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Substance abuse in Arizona

Substance abuse in Arizona, 1999

ARIZONA CR IMIN AL JUSTICE COMMISSION
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SUBSTANCE ABUSE IN ARIZONA
ARIZONA CRIMINAL JUSTICE COMMISSION
Chairman BARBARA LAWALL Pima County Attorney
Vice Chairman JAN BREWER Maricopa County Board of Supervisors
TERRY L. STEWART, Director Department of Corrections
DENNIS GARRETT, Director Department of Public Safety
KATHRYN D. BROWN, Chairman Board of Executive Clemency
DAVID K. BYERS, Director Administrative Office of the Courts
JANET NAPOLITANO Attorney General
WILLIAM HOLOHAN Chief Justice Retired
RICHARD M. ROMLEY Maricopa County Attorney
WILLIAM ROBINSON, Chief Yuma Police Department
CHARLES HASTINGS Yavapai County Attorney
CLARENCE DUPNIK Pima County Sheriff
TOM SHEAHAN Mohave County Sheriff
JOSEPH ARPAIO Maricopa County Sheriff
Executive Director MICHAEL D. BRANHAM Statistical Analysis Center Director MICHELLE C. WATKINS Research and Statistical Analyst CARIE ANN MCKENNA
ARIZONA CR IMIN AL JUSTICE COMMISSION
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SUBSTANCE ABUSE IN ARIZONA
THIS PUBLICATION WAS SUPPORTED BY AWARD NO. 99-DB-MU-0004 AWARDED BY THE BUREAU OF JUSTICE ASSISTANCE, OFFICE OF JUSTICE PROGRAMS. THE OPINIONS, FINDINGS,
AND CONCLUSIONS OR R COMMENDATIONS EXPRESSED IN THIS PUBLICATION ARE THOSE OF E THE AUTHOR(S) AND DO NOT NECESSARILY REFLECT THE VIEWS OF THE DEPARTMENT OF
JUSTICE. THIS DOCUMENT IS AVAILABLE IN ALTERNATIVE FORMATS BY CONTACTING THE COMMISSION OFFICE AT (602) 230-0252.
TABLE OF CONTENTS
EXECUTIVE SUMMARY ............................................................................................................ 3 INTRODUCTION ............................................................................................................................. 3 Public School Substance Use Survey...........................Error! Bookmark not defined. Adult Probation Officer Group Interviews ..................... Error! Bookmark not defined. REPORT OVERVIEW..............................................................ERROR! BOOKMARK NOT DEFINED. Elementary School Students .......................................... Error! Bookmark not defined. Junior High/Middle School Students ............................. Error! Bookmark not defined. High School Students ...................................................... Error! Bookmark not defined. Substance Abuse Among Adult Probationers..............Error! Bookmark not defined. CONCLUSION.........................................................................ERROR! BOOKMARK NOT DEFINED. INTRODUCTION .......................................................................................................................... 9 SUBSTANCE USE SURVEY HISTORY ......................................................................................... 10 The Student Surveys...........................................................................................................10 The Student Sample ........................................................................................................... 10 Student Survey Administration Procedure ...................................................................... 11 ADULT PROBATION OFFICER GROUP INTERVIEWS...................................................................11 REPORT OVERVIEW...................................................................................................................12 ELEMENTARY SCHOOL STUDENTS..................................................................................13 INTRODUCTION ........................................................................................................................... 13 PREVALENCE OF SUBSTANCE USE: EVER IN LIFE, IN LAST MONTH AND IN LAST WEEK........13 Comparison to 1997 Elementary School Substance Use Rates ................................. 14 TRENDS AMONG ELEMENTARY SCHOOL STUDENTS IN ARIZONA: 1991 TO 1999...................15 CONCLUSIONS............................................................................................................................17 JUNIOR HIGH/MIDDLE SCHOOL STUDENTS ................................................................... 19 INTRODUCTION ........................................................................................................................... 19 PREVALENCE OF SUBSTANCE USE: EVER IN LIFE, LAST MONTH AND LAST WEEK.................20 Comparison to 1997 Junior High School Substance Use Rates ................................. 20 TRENDS AMONG HIGH SCHOOL STUDENTS IN ARIZONA: 1991 TO 1999................................21 AGE AT FIRST USE: 1999..........................................................................................................24 DEMOGRAPHIC COMPARISONS: STUDENTS WHO HAVE USED A SUBSTANCE AT LEAST ONCE IN THEIR LIVES...........................................................................................................................24 SUBSTANCE USE WHILE ON SCHOOL GROUNDS......................................................................26 Attending School Under the Influence of Alcohol or Drugs .......................................... 26 Student Use of Drugs or Alcohol at School.....................................................................27 ATTITUDES AND PERCEPTIONS CONCERNING SUBSTANCE USE..............................................28 Perceived Effect of Substance Use on Social Life and Attitude Toward School.......28 Attitudes Concerning Peer Substance Use and Related Behaviors ........................... 28 Driving Under the Influence of Alcohol or Drugs ............................................................ 29 Differences in Attitudes between Students That Do/Do Not Use Substances .......... 30 RELATIONSHIP BETWEEN SUBSTANCE USE AND SELECTED FACTORS ................................... 30 School Achievement ........................................................................................................... 30
Substance Abuse in Arizona: 1999 1
Participation in Extracurricular Activities..........................................................................32 CONCLUSIONS............................................................................................................................33 HIGH SCHOOL STUDENTS....................................................................................................35 INTRODUCTION ........................................................................................................................... 35 PREVALENCE OF SUBSTANCE USE: EVER IN LIFE, LAST MONTH AND LAST WEEK.................35 Comparison to 1997 High School Substance Use Rates ............................................. 36 Comparison to 1998 National Data of High School Seniors.........................................36 TRENDS AMONG HIGH SCHOOL STUDENTS IN ARIZONA: 1991 TO 1999................................37 AGE AT FIRST USE: 1999..........................................................................................................40 DEMOGRAPHIC COMPARISONS: STUDENTS WHO HAVE USED A SUBSTANCE AT LEAST ONCE IN THEIR LIVES...........................................................................................................................40 SUBSTANCE USE WHILE ON SCHOOL GROUNDS......................................................................42 Attending School Under the Influence of Alcohol or Drugs .......................................... 42 Student Use of Drugs or Alcohol at School.....................................................................43 ATTITUDES AND PERCEPTIONS CONCERNING SUBSTANCE USE..............................................44 Perceived Effect of Substance Use on Social Life and Attitude Toward School.......44 Attitudes Concerning Peer Substance Use and Related Behaviors ........................... 44 Driving Under the Influence of Alcohol or Drugs ............................................................ 45 Differences in Attitudes Between Students That Do/Do Not Use Substances .......... 46 RELATIONSHIP BETWEEN SUBSTANCE USE AND SELECTED FACTORS ................................... 46 School Achievement ........................................................................................................... 46 Participation in Extracurricular Activities..........................................................................48 CONCLUSIONS............................................................................................................................49 ADULT PROBATIONER SUBSTANCE USE ....................................................................... 51 INTRODUCTION ........................................................................................................................... 51 PROBATIONER DRUGS OF CHOICE............................................................................................52 ASSESSMENT OF PROBATIONERS ............................................................................................. 54 SERVICES AVAILABLE TO PROBATIONERS ................................................................................ 54 Differences in Programs Between Counties ................................................................... 56 Barriers to Services ............................................................................................................. 57 REPORTED TRENDS IN PROBATIONERS' SUBSTANCE USE ...................................................... 57 Women on Probation .......................................................................................................... 57 WHAT'S MISSING ....................................................................................................................... 58 CONCLUSIONS............................................................................................................................59 CONCLUSIONS.........................................................................................................................61 ACKNOWLEDGEMENTS ........................................................................................................ 63 APPENDIX A .............................................................................................................................. 65 ELEMENTARY SUBSTANCE ABUSE SURVEY..............................................................................65 APPENDIX B .............................................................................................................................. 75 SECONDARY SUBSTANCE ABUSE SURVEY ............................................................................... 75
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Substance Abuse in Arizona: 1999
EXECUTIVE SUMMARY
Introduction
Arizona Revised Statute 41-2416 requires that the Arizona Criminal Justice Commission conduct a statewide survey to "measure both the attitudes and the actual prevalence and frequency of substance abuse by children and adults." In accordance with ARS 41-2416, the ACJC Statistical Analysis Center conducted two separate drug use evaluations of: 1) statewide public school students in grades three through twelve; and 2) probation officers across the state about adult probationer drug use. The results of these surveys have been compared to previous data and are detailed in this executive summary. Arizona is unique to the rest of the nation in that our drug use patterns differ from those shown on a national level. Prior to creating policy or evaluating the effects of state programs, it is important to look at data specific to the state of Arizona rather than national data alone. This report evaluated Arizona student's usage frequency of tobacco, smokeless tobacco, alcohol, marijuana, cocaine, meth/amphetamines, depressants, inhalants, hallucinogens, narcotics and steroids. Public School Substance Use Survey In 1988, the Arizona Criminal Justice Commission conducted its first substance use survey among high school students, college students and adults. Elementary and junior high/middle school participation began in 1990. Because of considerable legislative and public interest, the Substance Use Survey Program will continue to include a biennial assessment of elementary, junior high/middle and high schools. State public schools were randomly selected for participation in this survey. However, the sample was structured so that as many counties as possible would be proportionally represented. If a school declined participation, another was randomly selected from the same county. A total of 29 schools and 9,093 students participated in the 1999 survey. Of those, 968 are elementary students, 3,537 are junior high students and 4,588 are high school students. Participating schools administered the survey to all students in attendance in grades three through twelve. Two versions of the survey were administered: one for students in grades three through six and another for those in seventh through twelfth grades. While these two versions are very comparable, the secondary survey contains additional, and more in-depth, questions. The 1999 Substance Use Survey was administered in the fall of 1999. School principals and teachers were provided detailed instructions for administering the survey. Students' anonymity was emphasized and facilitated through the provision of blank
Substance Abuse in Arizona: 1999
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cover sheets to conceal answers while completing the survey. Upon completion, all surveys were returned to the Commission, whereupon the data was electronically scanned onto disk and results were analyzed. Individual schools' data were aggregated for this report to maintain confidentiality. Adult Probation Officer Group Interviews To gather information regarding adult substance use, all county adult probation officers involved in the Drug Treatment and Education Fund (DTEF) administered by the Arizona Administrative Office of the Courts were asked to participate in one of three regional group interviews with Commission staff. The purpose of the interviews was to generally discuss probationer attitudes and behaviors about substance use in order to gauge adult use among the general adult population. These probation officers (called the DTEF Coordinators) were selected as an interview group because of their work with adult offenders.
Report Overview
This report presents the findings of the 1999 public school student survey and the DTEF Coordinator group interviews. The 1999 student survey results were also compared to previous years, with elementary, junior high/middle and high school findings presented in separate sections. A general discussion of all results, alo ng with their generalizations and limitations, are presented thereafter. Elementary School Students The 1999 substance use survey shows that in comparison to earlier administrations of the survey almost all substance use among elementary school students is remaining constant. In terms of lifetime, monthly, and weekly use, elementary school students have generally maintained their levels of use since early administrations of the survey, even though a limited number of schools participated. Junior High/Middle School Students In 1999, almost all substance use among junior high school students remained consistent with what was reported in 1997. In terms of lifetime, monthly, and weekly use, junior high school students have generally either decreased or maintained their levels of use. With two exceptions, female junior high school students are using substances at similar rates to male students. Of those surveyed, females tend to use inhalants at a rate 24 percent higher than that of males in the same grade. The largest difference between male and female use occurs in smokeless tobacco use, which is used twice as often among male students.
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Substance Abuse in Arizona: 1999
The majority of junior high school students reported they disapproved of smoking in 1999. Of the students who reported approval of smoking, more approved of smoking in 1999 than was reported in 1997. The approval rate was higher among students who currently smoke than those that do not smoke. Among students who have used alcohol, attitudes toward alcohol use have not significantly changed since 1997: slightly more students who have never used alcohol approve of its use by their peers. Junior high school students who make better grades tend to use substances less frequently than those students who make lower grades, and students who participate in extracurricular activities tend to use substances less frequently than students who do not participate. Employed students report higher usage rates for all evaluated substance categories than those students who are not employed. Of the 19.1 % employed junior high school students, 73.8% reported using substances at least once in their lifetime. High School Students According to the 1999 survey results, alcohol and cigarettes are the most frequently used substances among high school students. Marijuana is the third most commonly used substance across all three temporal measures. Over three quarters of surveyed high school students reported trying alcohol, 62.6 percent reported trying cigarettes, and 49.5 percent reported trying marijuana. A comparison between Arizona high school seniors in 1999 and national high school seniors in 1998 shows that the proportions of Arizona seniors who have smoked cigarettes or had alcohol are comparable to other seniors across the nation. However, fewer Arizona seniors are smoking on a monthly basis in comparison to national figures. (This could be due to the strong presence of anti-smoking campaigns such as the Tobacco Education Prevention Program (TEPP), which is a branch of the Arizona Department of Health Services.) Overall, when comparing substance use among high school seniors with previously collected data, cigarette, smokeless tobacco and methamphetamine use have all decreased. Students tend to disapprove of substance use more often than they approve of it. Cigarette use, which is one of the more common substances used among the high school population, is the substance that most students believe it is the user's choice to smoke; however, only 4.2 percent of students approve of smoking. Alcohol, another popular substance, produces much the same attitudes as cigarette use, but more students (11.1 percent) approve of its use. In general, a higher percentage of students reported an attitude of disapproval for all substances in 1999 than was reported by students in 1997. Comparing the substance use rates between males and females shows that females are now using substances at similar rates to males.
Substance Abuse in Arizona: 1999
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As was seen among junior high students, high school students who participate in extracurricular activities tend to use substances less frequently than students who do not participate. Employed students report higher usage rates for all evaluated substance categories than those students who are not employed. Of the 42.5 % employed high school students, 87.6 % reported using substances at least once in their lifetime. Substance Abuse Among Adult Probationers In the spring of 2000, staff from the Arizona Criminal Justice Commission met in a group interview format with probation officers from across the state to discuss drug use among adult probationers. The purpose of these interviews was to learn more about adult substance use. The highlights from those interviews are described in this section. The probation officers almost unanimously agreed that alcohol, marijuana, methamphetamine and cocaine were the most abused drugs among adult probationers in their respective counties. While this is generally true across Arizona, these four drugs are in no particular order; methamphetamine may be the drug of choice in one area while cocaine is the drug of choice in another area. Providing drug treatment to the probationers using these substances creates challenges for the probation departments. While there are no formal research-based strategies for dealing with substance abusing offenders, all are assessed at intake to determine drug treatment needs. Many probation departments have too few providers able to handle the necessary services needed by probationers. Some counties have partially solved this problem by sharing services with neighboring counties. For example, in providing residential treatment, many rural counties send their probationers to Maricopa and/or Pima counties because they are more equipped to provide these services. The probation officers participating in the group interviews provided great insight related to substance abuse trends among adult probationers. Some of the trends and facts they reported were: Marijuana, alcohol, cocaine and methamphetamine are the drugs of choice of probationers. While it is not widespread, the probation officers reported they were witnessing more adults and juveniles becoming involved in the transportation/distribution of drugs. The probation officers reported that most probationers have a moderate to severe substance problem, and of these offenders, most were under the influence of drugs at the time of the offense. In their meeting, the central counties (Gila, Maricopa, Pima, and Pinal) called for a three pronged approach to the treatment of probationers. They said the probationer, the probation officer and the treatment providers need to work together as a team to help the probationer achieve the conditions of their probation. However, the officers reported this is sometimes difficult because some treatment providers will work only on the condition of confidentiality. While all counties acknowledged that the family component was an important one and that family support programs were needed, much less work is
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Substance Abuse in Arizona: 1999
done with the families. The main reason given for not working more closely with the families is that a family member or members cannot be required to attend any counseling or other sessions when the probationer is an adult--only the adult probationer can be required to participate. For some probation departments, giving the probation department or court more tools to affect change should be examined. These include the ability to impose jail time when conditions are not met, incentives to keep the probationers off drugs and other sanctions in general that could serve as a "hammer" for continued abuse/neglect of the conditions of probation. Also, almost all counties stated they would like more in-house programs that are longer and are conducted with smaller groups of probationers (lower staff to probationer ratio). Those programs that are in place should include an outcome evaluation. Finally, the probation officers described a lack of services that stems from one or both of the following: (1) lack of funds; or (2) grants that are too tightly controlled. An example of a lack of funds is that placing one probationer in residential treatment can deplete funds, leaving other probationers without the funds for appropriate services. Some materials are simply too expensive given the allowed budget. While there has always be an argument that money is too tight, there are instances when funds set aside for a specific purpose are so stringent that the funds aren't able to be spent even though it conforms with the mission of the fund. For example, substance abusers that committed an act of domestic violence or other violent crime are not eligible for substance abuse treatment for limited jurisdiction cases, but some Superior Courts believe these probationers should be eligible for services under the grant. The Arizona Criminal Justice Commission's public school substance use survey and group interviews with probation officers yield very important and useful data. The substance use survey provides an estimate of the number of our youth using both legal and illicit substances and the frequency at which they are used. The adult probation officer group interviews shed some light on adult substance patterns that are closely related to the use experienced by the adult population. The full report provides a more comprehensive discussion of the results of both these projects.
Conclusion
The connection between public school student substance abuse and the substance patterns of probationers is apparent. This report shows that methamphetamine, marijuana, alcohol and cocaine are the most heavily u ed illicit substances in society s today, both among high school students and among adult probationers. The criminal justice community is well aware and has documented the relationship between drug use and criminal activity, and until we can reduce the prevalence of drug use we are likely to see continued illegal behaviors. For these reasons, the criminal justice community is in support of drug prevention education as a method of preventing criminal drug-related activity in the future.
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A focus on drug prevention programs that have proven effective in the classroom, coupled with a focus on the current needs of the criminal justice system to provide quality drug treatment in all areas of the state are critical to increasing the effectiveness of the criminal justice system. In addition, it is suggested the drug treatment needs of citizens outside of the criminal justice system be assessed in an effort to keep them from ever entering the criminal justice system. These priorities will advance the criminal justice system in its overall mission to reduce crime and increase safety in all Arizona communities.
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Substance Abuse in Arizona: 1999
INTRODUCTION
Arizona Revised Statute 41-2416 requires that the Arizona Criminal Justice Commission conduct a statewide survey to "measure both the attitudes and the actual prevalence and frequency of substance abuse by children and adults." This report has been created to fulfill this requirement. The following sections of this report will further describe the public school student substance use survey and adult probation officer group interviews. When looking at substance use throughout Arizona, it is important to look at data specific to the state of Arizona rather than national data. Arizona has unique circumstances that create drug use patterns different than those shown on a national level. For example, a national study by the Partnership for a Drug -Free America shows that marijuana use has stabilized and that other illicit drug use has declined; however, this is not necessarily the case in Arizona 1. Of special interest is the information in the student substance abuse survey results regarding attitudes toward drug use. According to the University of Michigan's Monitoring the Future study, the "perception of risk (how risky consumers view a particular drug) and perception of social disapproval (consumer appeal and acceptance of a particular drug)" have helped to guide substance consumption patterns (Partnership for a Drug-Free America, 5). 2 For this reason, the lack of social disapproval among students about student use, such as the common attitudes reported here that student use of drugs is the decision of the user, is an important predictor of future increases in drug use. To collect substance use information throughout Arizona, the Arizona Criminal Justice Commission's Statistical Analysis Center conducted two separate evaluations. First, a survey was administered in a statewide sample of public schools. Teachers working in the selected schools administered the survey to students in grades three through twelve. The Commission has been conducting this survey for twelve years on a biennial basis, and the results of this survey along with those of prior years will be compared. Secondly, Commission staff talked with adult probation officers about adult probationer use by conducting three group interviews across the state. This is the first time in over a decade that the Commission was able to successfully report on adult prevalence. Future plans include further exploration of this area.
1
Partnership for a Drug-Free America (2000). More Parents Talking with Kids About Drugs More Often, And Appear to Be Having An Impact. April 11, 2000 Press Release. 2 Partnership for a Drug-Free America (2000). Partnership Attitudes Tracking Study: Spring 1999 Parents. 9
Substance Abuse in Arizona: 1999
Substance Use Survey History
In 1988, the Arizona Criminal Justice Commission conducted its first substance use survey among high school students, college students and adults. This groundbreaking survey allowed for the development of baseline information on substance use levels in the state. Elementary and junior high/middle school participation began in 1990. University and community college surveys were performed in 1988, 1990, and 1991, and general public substance use surveys were conducted in 1988 and 1990. Because of considerable legislative and public interest, the Substance Use Survey Program will continue to include a biennial assessment of elementary, junior high/middle and high schools. The college and general public surveys will be conducted whenever feasible given a vailable resources. The Student Surveys The Arizona Public School Substance Use Survey was revised in 1997 prior to administration to improve its organization, comprehensiveness, and comprehension. It measures the prevalence, frequency, and effects of, as well as attitudes toward, substance use of youth enrolled in Arizona primary and secondary public schools. The survey also contains questions about gangs, such as personal involvement, the perceived presence of gang members in one's family, school, and neighborhood, and illegal gang activities. In 1997, questions were added regarding weapons and perceived safety while at school. Finally, demographic variables, school attitude and achievement, and extracurricular activity involvement are measured. Althoug h the 1997 survey was designed to allow for comparison with previous years' data, it is possible that changes to the survey (e.g., content, format, order of the questions, etc.) affect its comparability. For example, short descriptions of each substance we re added, including common "street names," to improve the survey's comprehension. While this may not initially appear problematic, students may report higher or lower levels of use simply because they better understand the meaning of the surveyed substances.
The Student Sample
State public schools were randomly selected for participation in this survey. However, the sample was structured so that as many counties as possible would be proportionally represented. (Representation of all counties is not required in the statewide sample as long as an excluded county is represented regionally through an adjoining county's participation.) If a school declined participation, another was randomly selected from the same county to replace it. Several school administrators declined participation in the project, for a variety of reasons, and other schools dropped out of the sample after confirming participation. While a reduced participation rate can affect the survey results and the sample, it is very common and virtually unavoidable in this type of research.
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Substance Abuse in Arizona: 1999
A total of 29 schools and 9,093 students participated in the 1999 survey. Of those, 968 were elementary students, 3,537 were junior high students, and 4,588 were high school students. Because a limited number of elementary schools participated in the survey, the elementary school results cannot be considered representative of the entire state and are therefore best interpreted with caution. Participating schools administered the survey to all students in attendance in grades three through twelve. Two versions of the survey were administered: one for students in grades three through six and another for those in seventh through twelfth grades. While the two versions are very comparable, the secondary survey contains additional, and more in depth, questions. Student Survey Administration Procedure The 1999 Substance Use Survey was administered in the fall of 1999. School principals and teachers were provided detailed instructions to use when administering the survey. Surveys were to be administered to students within each school without prior notice, at the same time, and in students' regular classroom setting, whenever possible. Students' anonymity was emphasized and facilitated through the provision of blank cover sheets to conceal answers while completing the survey. Elementary teachers (grades three through six) were instructed to read the survey aloud as students completed it to aid comprehension of the questions. Once administration was completed, teachers were instructed to immediately seal their class' surveys in a provided envelope. Upon completion, all surveys were returned to the Commission, electronically scanned onto disk, and analyzed. Individual schools' data were aggregated for this report to maintain confidentiality.
Adult Probation Officer Group Interviews
To gather information regarding adult substance use, all county adult probation officers involved in the Drug Treatment and Education Fund (DTEF) administered by the Arizona Administrative Office of the Courts were asked to participate in one of three regional group interviews with Commission staff. Representatives from all but two counties (Greenlee and La Paz) participated in the interviews. The purpose of the interviews was to generally discuss probationers' attitudes and behaviors about substance use in order to gauge adult use among the general adult population. These probation officers (called the DTEF Coordinators) were selected as an interview group because of their work with adult probationers. The substance use patterns of adult probationers was explored because their substance use patterns are more widely known than the general population. Because it is expensive to reach the general adult population by telephone interviews or written questionnaires, adult probationers were chosen for study because they are a more accessible group of adults to study than the general population.
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Report Overview
The remainder of this report presents the findings of the 1999 public school student survey and the DTEF Coordinator group interviews. The 1999 student survey results are also compared to previous years, with elementary, junior high/middle, and high school findings presented in separate sections. A discussion of adult probationer substance abuse is presented thereafter. The Appendix at the end of the report contains copies of the elementary and secondary student survey instruments used in 1999. Care must be taken not to draw cause and effect conclusions from the data contained in the public school student survey portions of this report. If one group of students yields higher levels of use than another group (e.g., females compared to males), it cannot be concluded that group membership alone (e.g., sex) causes the resulting levels of use. While different groups may yield different levels of substance use, it can only be concluded that there may be some type of relationship between that variable (e.g., sex) and substance use, not that the variable causes certain levels of substance use. Factors other than group membership that was not measured by the survey may be contributing to the observed relationships between variables. Such possibilities can be explored through more detailed research projects.
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Substance Abuse in Arizona: 1999
ELEMENTARY SCHOOL STUDENTS
Introduction
In recent years, drug prevention efforts have been targeted at students in lower grades in response to increasing use among elementary school students. This chapter will discuss the frequency of substance use among elementary school students and how this use has changed in the last decade. A total of 971 elementary public school students across the state participated in the 1999 Substance Use Survey. More rural schools participated than urban schools, which is of some concern because about 60% of Arizona's population reside in metropolitan areas. The sample contains 49.0% females and 51.0% males, and is thus representative of the state's population of elementary public school students. The race composition of the elementary sample is the following: 30.2% White (not Hispanic), 54.9% Hispanic, 4.3% American Indian, 3.1% Black (not Hispanic), and 7.5% Other (including Asian). Although White students are somewhat under represented and Hispanic students are somewhat over represented, the figures compare well to the state population of public school students in grades three through six. The grade distribution of the sample is relatively even: 26.3% of the students surveyed are in the third grade, 29.1% are in fourth grade, 24.5% are in fifth grade, and 20.1% are in the sixth grade. These figures compare well to the state's population of elementary students. The smaller proportion of sixth graders is partially accounted for by the fact that some school districts enroll their sixth graders in junior high rather than elementary school. This group of students will be represented in the junior high/middle school section of the report. These data were not analyzed with the elementary sample due to the fact that simply attending a middle school may affect reported behaviors and experiences.
Prevalence of Substance Use: Ever in Life, In Last Month and In Last Week
The 1999 survey of elementary school students shows that alcohol and cigarettes are the substances most commonly used among third through sixth graders (see Table 11). Overall, about one in every four elementary students has used alcohol before, and 16.8% of all elementary students have used cigarettes. Inhalant use among respondents is also common: it has been used by 8.9% of elementary school students. Smokeless tobacco and marijuana have been used by the same proportion of elementary school students with about 6% of students trying each drug. Each of the remaining six substances have been tried by 3.5% or fewer students. Use of all substances declines considerably as the frequency of use increases. Among elementary school students, this is especially apparent for cigarettes, alcohol, and smokeless tobacco, where use in the last month is approximately one fourth the proportion of students who have ever tried the substance in their life. Overall, it appears
Substance Abuse in Arizona: 1999
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that approximately half of elementary school students who have tried the surveyed substances may have done so in an experimental manner and/or have not recently used. The differences between the proportion of elementary students reporting use in the last month and in the last week are considerably smaller. For many of the substances, there is no difference between the proportion of students reporting last month and last week use. This may indicate that those elementary students who have used in the last month are also regular, weekly users.
Table 1-1
ELEMENTARY SCHOOL STUDENTS 1999 Substance Use: Ever in Life, In Last Month and In Last Week
Substance Cigarettes Smokeless Tobacco Alcohol Marijuana Cocaine Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids Ever in Life 16.8% 6.2% 24.4% 6.3% 3.5% 3.0% 2.3% 8.9% 2.2% 3.1% 2.7% In Last Month 4.6% 1.8% 6.6% 3.2% 1.5% 1.2% <1% 4.3% 1.5% 1.7% 1.7% In Last Week 4.4% 2.4% 4.7% 3.0% 1.4% 1.3% 1.2% 3.3% 1.9% 1.2% 1.4%
Comparison to 1997 Elementary School Substance Use Rates While the rates just presented provide a snapshot of substance use, actual increase or decreases become clear when the rates are compared to the rates reported in 1997. In making this comparison, we can see that among all students who have used (in their lifetime, in the last month, and/or in the last week): Cigarette, marijuana, and inhalant use is lower than was reported in 1997; Alcohol use has increased by 23% in comparison to 1997; and All other drugs have not changed in terms of rate of use between 1997 and 1999.
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Substance Abuse in Arizona: 1999
Table 1-2
ELEMENTARY SCHOOL STUDENTS Substance Use Ever in Life: 1991-1999 Comparison
Substance Cigarettes Smokeless Tobacco Alcohol Marijuana Cocaine Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids 1991 17.2% 5.8% 39.0% 1.7% 0.7% 1.0% N/A 5.9% 1.2% N/A N/A 1993 18.4% 9.8% 30.5% 3.1% 1.4% 1.3% N/A 7.3% 1.6% N/A N/A 1995 16.6% 5.3% 29.2% 5.6% 2.0% 2.1% N/A 6.8% 1.4% N/A N/A 1997 18.3% 6.0% 19.9% 8.2% 3.5% 2.8% 2.3% 10.4% 2.6% 2.2% 2.2% 1999 16.8% 6.2% 24.4% 6.3% 3.5% 3.0% 2.3% 8.9% 2.2% 3.1% 2.7%
Note: This information is not available for depressants, narcotics, or steroids prior to 1997.
Trends Among Elementary School Students in Arizona: 1991 to 1999
A comparison of public elementary school students' use from 1991 to 1999 reveals that use levels for most substances (for which data are available) have changed little over time. Tables 1-2, 1-3, and 1-4 show this is consistent for all three temporal measures of use: ever in life, in the last month, and in the last week. However, an increase in the percent of students who have ever tried a drug does indicate use in the last month or the last week is rising as well. Overall, when looking at the trends of use for each substance the data show: Cigarette use has not changed substantially in terms of lifetime, monthly, or weekly use. Smokeless tobacco use among students who have ever tried the drug rose significantly in 1993, but has been constant ever since. For monthly and weekly use, there have been minimal changes in use. Alcohol lifetime use has increased since 1997, but is still lower than 1991-1995 rates, and monthly use is lower than 1993 and 1995 rates. Weekly use has not changed since 1997, but is slightly lower than the 1995 rate. Monthly, weekly, and lifetime marijuana use has not changed significantly. Cocaine use has not drastically changed in any of the three areas. No large changes in methamphetamine, depressant, hallucinogen, narcotic, or steroid use appears to have occurred over time. Inhalant use in lifetime decreased slightly since 1997. No substantial changes have occurred in monthly and weekly use.
Substance Abuse in Arizona: 1999
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Table 1-3
ELEMENTARY SCHOOL STUDENTS Substance Use In the Last Month: 1991-1999 Comparison
Substance Cigarettes Smokeless Tobacco Alcohol Marijuana Cocaine Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids 1991 N/A N/A 3.5% 0.3% 0.2% 0.1% N/A 0.9% 0.3% N/A N/A 1993 N/A N/A 10.4% 1.8% 0.4% 0.8% N/A 3.3% 0.9% N/A N/A 1995 N/A N/A 10.6% 3.2% 1.6% 1.6% N/A 3.4% 1.0% N/A N/A 1997 5.7% 2.6% 6.0% 4.0% 1.9% 1.4% 1.3% 4.9% 1.5% 1.0% 1.2% 1999 4.6% 1.8% 6.6% 3.2% 1.5% 1.2% <1% 4.3% 1.5% 1.7% 1.7%
Note: This information is not available for cigarettes, smokeless tobacco, depressants, narcotics, or steroids prior to 1997.
Table 1-4
ELEMENTARY SCHOOL STUDENTS Substance Use In the Last Week: 1993 - 1999 Comparison
Substance Cigarettes Smokeless Tobacco Alcohol Marijuana Cocaine Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids 1993 N/A N/A 5.5% 0.8% 0.3% 0.6% N/A 1.9% 0.6% N/A N/A 1995 N/A N/A 6.8% 2.3% 1.0% 1.3% N/A 2.6% 1.0% N/A N/A 1997 4.5% 2.2% 4.2% 3.2% 1.6% 1.4% 1.2% 4.1% 1.2% 1.1% 1.1% 1999 4.4% 2.4% 4.7% 3.0% 1.4% 1.3% 1.2% 3.3% 1.9% 1.2% 1.4%
Note: Use in the last week was not measured prior to 1993. Also, this information is not available for cigarettes, smokeless tobacco, depressants, narcotics, or steroids prior to 1997.
16
Substance Abuse in Arizona: 1999
Conclusions
A review of substance use among elementary school students at the present time and from previous years indicates that: Most substance use among elementary school students is remaining constant. In terms of lifetime, monthly and weekly use, elementary school students have generally maintained their levels of use.
Substance Abuse in Arizona: 1999
17
18
Substance Abuse in Arizona: 1999
JUNIOR HIGH/MIDDLE SCHOOL STUDENTS
Introduction
Junior high/middle school years are the "experimental" years for substance use. The results of the Criminal Justice Commission's survey of high school students indicates that among students who have ever tried substances in their lives, smokeless tobacco, cocaine, methamphetamine, depressant, hallucinogen, narcotic and steroids were most commonly tried between the ages of 14 and 16. Cigarette, marijuana and inhalant use begins most commonly between the ages of 11 and 133. Exploratory substance usage patterns of junior high school students are different from substance use by high school students, and at different rates. Through monitoring junior high school students' substance use patterns during this experimentation period, their future drug use can be forecasted more clearly. The substance use behaviors of junior high/middle school students are the focus of this chapter. When conducting surveys across the state using a sample of students rather than the entire student population, efforts were made to ensure that the sample of students was representative of the entire student population. In 1999, a total of 3,537 public high school students across the state participated in the substance use survey. The sex, race and grade distributions presented here represent the sample surveyed. The sex breakdown of the 1999 junior high school sample is as follows: 49.5% females and 50.5% males. These figures correlate with the state's population of junior high school students. Therefore, it can be assumed that any differences in the results on the basis of sex will not be due to the sample. The racial make-up of the junior high school sample was also similar to the racial breakdown of Arizona junior high school students. The racial breakdown is as follows: 35.9% White (not Hispanic), 35.6% Hispanic, 12.1% American Indian, 4.1% Black (not Hispanic), and 12.3% Other (including Asian) 4. It is assumed that any differences in the results on the basis of race are not due to the sample construction. The grade ranges represented in the sample contain similar proportions of seventh and eighth grade students (37.9% and 43.9% respectively). The junior high/middle school sample also contains a small proportion of sixth graders (11.5%) and some ninth graders (5.9%) because some school districts enroll their sixth and/or ninth graders in junior high rather than in elementary or high schools.
3
More information regarding substance use among high school students will be reported in the following chapter. 4 Asian and Other race categories were combined and will be reported as such. This was done because the sample of Asian students was relatively small and the initial results of Asian substance use were inflated. 19
Substance Abuse in Arizona: 1999
Prevalence of Substance Use: Ever in Life, Last Month and Last Week
According to the 1999 survey results, alcohol, cigarettes and marijuana are the most frequently used substances among junior high school students (see Table 2-1). Alcohol and cigarettes are the most frequently used substances, with 50.7% of students reporting they had used alcohol at least once in their lives, and 41.0% of students reporting they had ever used cigarettes. Marijuana is the third most commonly used substance, with almost one in four students reporting they have used it at least one time in their lives. In all, 19.8% of junior high school students reported trying inhalants. Each of the remaining illicit substances have been used by less than eight percent of junior high school students. Overall, the percentages of junior high school students who have used substances in the last month are approximately one half of the lifetime use numbers. This would indicate that large proportions of the state's junior high/middle school students who have tried the surveyed substances are not regular and/or current users. For most substances, use in the last week does not show as considerable a drop from last month use figures. However, alcohol use in the last week drops about 35% from use in the last month. Alcohol is the most widely tried substance, and numbers show that about one quarter of students who have tried alcohol have actually used it in the last week, and may well be frequent users.
Table 2-1
JUNIOR HIGH/MIDDLE SCHOOL STUDENTS 1999 Substance Use: Ever in Life, In Last Month, and In Last Week
Substance Cigarettes Smokeless Tobacco Alcohol Marijuana Cocaine Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids Ever in Life 41.0% 10.6% 50.7% 24.1% 7.1% 7.0% 6.9% 19.8% 7.6% 6.9% 6.4% In Last Month 13.0% 4.0% 21.3% 13.1% 4.1% 4.1% 4.2% 8.6% 4.5% 4.3% 4.3% In Last Week 10.1% 3.9% 13.8% 9.7% 3.6% 3.8% 3.7% 6.4% 3.5% 3.8% 4.0%
Comparison to 1997 Junior High School Substance Use Rates
The rates presented above do not indicate whether substance use is increasing or decreasing. However, looking at the rates in comparison to the rates reported in 1997 a better determination of substance use trends among Arizona high school students is obtained. A comparison of the 1999 survey results to the 1997 results, shows that
20 Substance Abuse in Arizona: 1999
among all students who have used (in their lifetime, in the last month and/or in the last week): Cigarette and alcohol use is lower in 1999 than in 1997, Depressant, cocaine, methamphetamine, hallucinogen, narcotic, smokeless tobacco, marijuana and inhalant use has not changed, and Steroid use is higher in 1999 than it was in 1997. A more in-depth discussion of these trends is presented in the next section of this chapter.
Trends Among Junior High School Students in Arizona: 1991 to 1999
A comparison of public junior high school students' use from 1991 to 1999 reveals that use levels for most substances (for which data are available) have fluctuated over this time. Tables 2-2, 2-3, and 2-4 show this is consistent for all three temporal measures of use: ever in life, in the last month and in the last week. However, because substance use may be rising among students who have ever tried a substance in their lives, continued use (such as on a monthly or weekly basis) may not have increased. In some instances, the increased proportion of students trying a substance, but not using it regularly, indicates that students have made a decision not to use the substance after they have tried it.
Table 2-2
JUNIOR HIGH/MIDDLE SCHOOL STUDENTS Substance Use Ever in Life: 1991-1999 Comparison
Substance Cigarettes Smokeless Tobacco Alcohol Marijuana Cocaine Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids 1991 N/A N/A 49.5% 12.3% 3.7% 4.1% 11.0% 14.8% 4.7% 6.1% N/A 1993 N/A N/A 46.1% 19.1% 5.2% 5.7% 11.2% 18.6% 6.4% 6.3% 2.8% 1995 N/A N/A 46.2% 19.1% 6.3% 7.9% 11.0% 17.5% 7.5% 6.0% 3.2% 1997 45.9% 10.9% 54.9% 25.8% 6.1% 5.8% 6.3% 21.1% 6.7% 5.8% 3.6% 1999 41.0% 10.6% 50.7% 24.1% 7.1% 7.0% 6.9% 19.8% 7.6% 6.9% 6.4%
Note: This information is not available for cigarettes or smokeless tobacco prior to 1997.
Substance Abuse in Arizona: 1999
21
Overall, when looking at the trends of use for each substance the data demonstrates that: Cigarette use is slightly lower than the 1997 figure. Monthly use has decreased since its peak i n 1997. Smokeless tobacco use has not changed. Overall alcohol use (in the last week, in the last month and in lifetime) has changed little over time. The proportion of students who have ever used marijuana increased between 1991 and 1997, but has not changed in comparison to 1997 figures. Cocaine use has increased slightly in the three areas: lifetime, monthly and weekly use. Methamphetamine use for all three temporal measures has not changed overall. The percent of students who have tried depressants or used on a monthly or weekly basis has not changed significantly. Inhalant use has not changed in terms of lifetime, monthly or weekly use. Hallucinogen use ever in students' lifetimes has been relatively stable since 1993; monthly use has also remained constant since 1995, and weekly use has changed little. Narcotic use in lifetime, month and last week has remained relatively constant. The percent of students who have used steroids in their lifetime has risen since 1993.
Table 2-3
JUNIOR HIGH/MIDDLE SCHOOL STUDENTS Substance Use In the Last Month: 1991-1999 Comparison
Substance Cigarettes Smokeless Tobacco Alcohol Marijuana Cocaine Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids 1991 18.1% 5.9% 21.4% 5.0% 1.8% 2.3% N/A 7.2% 2.5% N/A N/A 1993 17.3% 7.5% 20.0% 9.4% 2.6% 2.4% N/A 7.3% 3.6% N/A N/A 1995 17.0% 7.1% 20.2% 9.0% 3.0% 3.8% N/A 7.6% 3.8% N/A N/A 1997 18.7% 3.4% 23.7% 13.6% 2.9% 2.6% 3.0% 8.6% 3.0% 2.8% 1.8% 1999 13.0% 4.0% 21.3% 13.1% 4.1% 4.1% 4.2% 8.6% 4.5% 4.3% 4.3%
Note: This information is not available for depressants, narcotics, or steroids prior to 1997.
22
Substance Abuse in Arizona: 1999
Table 2-4
JUNIOR HIGH/MIDDLE SCHOOL STUDENTS Substance Use In the Last Week: 1993 - 1999 Comparison
Substance Cigarettes Smokeless Tobacco Alcohol Marijuana Cocaine Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids 1993 N/A N/A 13.1% 8.1% 2.6% 2.5% N/A 5.7% 3.3% N/A N/A 1995 N/A N/A 19.4% 8.5% 3.3% 3.4% N/A 6.1% 3.4% N/A N/A 1997 12.6% 2.4% 12.5% 9.6% 2.1% 1.8% 2.1% 5.8% 1.8% 2.0% 1.6% 1999 10.1% 3.9% 13.8% 9.7% 3.6% 3.8% 3.7% 6.4% 3.5% 3.8% 4.0%
Note: Use in the last week was not measured prior to 1993. Also, this information is not available for cigarettes, smokeless tobacco, depressants, narcotics, or steroids prior to 1997.
Table 2-5
JUNIOR HIGH/MIDDLE SCHOOL STUDENTS 1999 Substance Use: Age at First Use
Substance Cigarettes Smokeless Tobacco Alcohol Marijuana Cocaine Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids 7 or younger 15.0% 17.6% 19.1% 5.1% 10.3% 8.9% 9.9% 8.3% 4.9% 8.5% 12.3% 8-10 40.0% 36.2% 31.2% 28.1% 11.9% 20.1% 19.4% 24.2% 16.7% 22.5% 13.0% 11-13 42.6% 41.5% 46.0% 61.2% 63.8% 60.4% 55.8% 61.9% 62.3% 60.1% 58.3% 14 or older 2.5% 4.7% 3.7% 5.5% 14.0% 10.7% 15.0% 5.7% 16.3% 9.0% 16.4%
Note: This table includes only those students who report ever using each substance.
Substance Abuse in Arizona: 1999
23
Age at First Use: 1999
Table 2-5 represents the age the surveyed substances were first used by junior high school students. Among junior high school students, the most common age of initiation of all substances was between the ages of 11 and 13. Cigarette, smokeless tobacco and alcohol use is frequently started among eight through ten-year olds as well.
Demographic Comparisons: Students Who Have Used a Substance at Least Once in Their Lives
To implement a drug prevention or intervention program, it is important to have detailed information on which students are participating in drug activities so the chances of successfully administering the program will increase. This section describes the prevalence of substance use among those students who have used a substance at least one time in their lives in more detail by breaking this use down by sex, race, and grade. The 1999 survey revealed that substance use, which used to be more prevalent among males than females, is now nearly as common among females as among males. This year's survey clearly reflects the closing of the gender gap in the survey results. Table 2-6 shows that: Females tend to use inhalants more frequently than their male counterparts. The largest difference between male and female use occurs in smokeless tobacco use, which is used more often among males. For all other drugs, female junior high school students use at about the same rate as male students.
Table 2-6
JUNIOR HIGH/MIDDLE SCHOOL STUDENTS 1999 Substance Use Ever in Life: Sex Comparison
Substance Cigarettes Smokeless Tobacco Alcohol Marijuana Cocaine Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids Female 39.7% 6.0% 49.7% 20.4% 5.3% 5.3% 5.4% 19.7% 5.4% 3.7% 3.4% Male 40.0% 11.9% 48.7% 23.4% 4.5% 4.4% 4.5% 15.9% 5.8% 5.5% 4.5%
A review of substance use among different races in Table 2-7 shows that American
24
Substance Abuse in Arizona: 1999
Indian students have the highest cigarette, smokeless tobacco, marijuana, and inhalant use rates. Black students reported the highest use of alcohol. Students self-reported as either an "other" racial identity or as Black have the highest rates of depressant use. The races that use substances most commonly in junior high school, however, are not the most frequent users among high school students. For more information on high school use, please refer to chapter three of this report.
Table 2-7
JUNIOR HIGH/MIDDLE SCHOOL STUDENTS 1999 Substance Use Ever in Life: Race Comparison
Substance Cigarettes Smokeless Tobacco Alcohol Marijuana Cocaine Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids White 37.3% 9.4% 49.5% 19.0% 3.2% 4.0% 5.0% 15.1% 5.1% 4.2% 3.4% Black 44.2% 6.5% 52.2% 27.5% 5.8% 5.8% 8.0% 13.8% 5.8% 5.1% 7.2% Hispanic 37.7% 5.6% 50.6% 19.2% 5.3% 4.9% 4.3% 18.8% 4.7% 4.5% 3.2% American Indian 51.2% 18.7% 42.1% 36.0% 7.9% 4.9% 3.9% 21.4% 7.6% 5.2% 4.2% Asian/ Other 40.2% 10.4% 50.4% 23.2% 6.3% 7.7% 7.5% 19.6% 8.7% 6.1% 7.0%
Almost all rates of substance use among junior high school students increase as they progress from seventh to eighth grade. For example, there is a 103.3% percent change in methamphetamine use between the seventh and eighth grades. Marijua na use is 85.4% higher among eighth graders than among seventh graders. The prevalence of substance use ever in life is presented by grade in Table 2-8.
Substance Abuse in Arizona: 1999
25
Table 2-8
JUNIOR HIGH/MIDDLE SCHOOL STUDENTS 1999 Substance Use Ever in Life: Grade Comparison
Substance Cigarettes Smokeless Tobacco Alcohol Marijuana Cocaine Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids Seventh 32.4% 7.3% 41.1% 15.8% 3.5% 3.0% 3.4% 16.0% 4.1% 3.2% 3.2% Eighth 47.7% 10.9% 59.7% 29.3% 6.0% 6.1% 6.0% 20.8% 7.0% 5.4% 4.4% Percent Increase Between Seventh and Eighth Grades 47.2% 49.3% 45.3% 85.4% 71.4% 103.3% 76.5% 30.0% 70.7% 68.8% 37.5%
Substance Use While on School Grounds
The Substance Use and Public School Students survey asks students not only about their own use patterns, but also about their attitudes toward substance use in general. In this section, the survey results examining substance use and school attendance will be presented.
Attending School Under the Influence of Alcohol or Drugs
In 1999, a smaller proportion of students reported that they had attended school under the influence of drugs than was reported in 1997. In 1999, 12.9% of students reported they had come to school under the influence of alcohol or drugs, which is slightly less than the 15.5% of students who reported the same behavior in 1997. Of the students who have come to school under the influence, most students have engaged in this behavior one or two times. Please see Table 2-9. (Totals may not add up to 100% because not all students surveyed answered the question.)
26
Substance Abuse in Arizona: 1999
Table 2-9
JUNIOR HIGH/MIDDLE SCHOOL STUDENTS 1999 Attending School Under the Influence of Alcohol or Drugs
Use of Alcohol or Drugs Have Never Used Have Used, But Have Never Attended School Under the Influence Have Attended School Under the Influence: - 1 or 2 times - 3 to 5 times - 6 to 9 times - 10 to 19 times - 20 to 39 times - 40 or more times Total Percentage 56.2% 28.1%
5.2% 2.5% 1.8% 1.0% 0.8% 1.6% 12.9%
Student Use of Drugs or Alcohol at School
When comparing the percent of students who attend school under the influence of alcohol or drugs to the percent of students who actually use while on school grounds, it appears that almost as many students use substances while on campus (10.1%). About 5% of surveyed junior high school students report using alcohol or drugs at school one or two times in their lives.
Table 2-10
JUNIOR HIGH/MIDDLE SCHOOL STUDENTS 1999 Use of Alcohol or Drugs at School (Ever in Life)
Use of Alcohol or Drugs Have Never Used Have Used, But Have Never Used at School During Regular School Hours Have Used at School During Regular School Hours: - 1 or 2 times - 3 to 5 times - 6 to 9 times - 10 to 19 times - 20 to 39 times - 40 or more times Total Percentage 57.1% 30.0%
5.1% 1.9% 1.0% 0.9% 0.4% 0.8% 10.1%
Substance Abuse in Arizona: 1999
27
Attitudes and Perceptions Concerning Substance Use
As stated previously, attitudes and perceptions of drug use tend to guide substance consumption patterns. This section examines attitudes about both self-reported and peer substance use and related behaviors. Also included is a comparison of attitudes toward peer behaviors by those students who have participated in the same behaviors.
Perceived Effect of Substance Use on Social Life and Attitude Toward School
The 1999 survey results indicate that approximately two thirds of junior high school students who have used alcohol or drugs believe that their use has not affected their social lives. Almost 70% of those who have used report no effect of their use on their attitude toward school. Of those students who report some type of effect on their social life, twice as many report positive versus negative effects. With regard to effect on attitude toward school, more students who had used alcohol or drugs reported a positive attitude toward school than a negative attitude. These results indicate that students have positive views on the impact of their own substance use than in 1997. See Table 2 -11.
Table 2-11
JUNIOR HIGH/MIDDLE SCHOOL STUDENTS 1999 Effect of Own Use of Alcohol or Drugs on Social Life and Attitude Toward School
Effect Very Positive Positive Negative Very Negative No Effect Social Life 11.4% 9.9% 6.1% 3.4% 69.2% Attitude Toward School 9.8% 7.8% 7.9% 3.9% 70.6%
Note: Only those students who have ever used alcohol or drugs are represented in this table.
Attitudes Concerning Peer Substance Use and Related Behaviors
Students were asked how they felt about someone their age using tobacco, alcohol and drugs. As the figures in Table 2-12 show, students tend to disapprove of substance use more often than approve of it. Cigarette use, one of the more common substances used among the junior high school population, is the substance in which most students think it is the user's own choice to smoke; howe ver, only 8.0% of students approve of its use. Alcohol, another popular substance, produces much the same attitudes as cigarette use, but more students (9.8%) approve of its use. Attitudes of disapproval of drug use and smokeless tobacco use are the most common attitudes toward these substances. Of junior high school students, 64.2% disapprove of driving under the influence of alcohol, and 62.6% disapprove of driving under the influence of drugs. The percentages of junior high school students who disapprove of these behaviors are lower than the percentages reported by high school students, indicating that in general, high school
28
Substance Abuse in Arizona: 1999
students disapprove of substance use more than junior high school students do. In comparison to 1997, about the same percentage of junior high school students reported an attitude of disapproval for all substances in 1999 than was reported by students in 1997. However, because junior high school students disagree with substance use does not necessarily mean that the respondent hasn't personally used substances. A comparison between substance use attitudes and self-reported use is explored in a later section of this report.
Table 2-12
JUNIOR HIGH/MIDDLE SCHOOL STUDENTS 1999 Attitudes Toward Peer Substance Use and Related Behaviors
Substance/Behavior Cigarettes Smokeless Tobacco Alcohol Drugs DUI: Alcohol DUI: Drugs Approve 8.0% 7.6% 9.8% 8.4% 7.6% 7.7% Do Not Care (No Opinion) 17.4% 17.2% 17.7% 15.0% 11.4% 11.7% Do Not Mind (Own Choice) 35.4% 29.7% 34.2% 27.6% 16.8% 18.0% Disapprove 39.3% 45.5% 38.3% 49.0% 64.2% 62.6%
Driving Under the Influence of Alcohol or Drugs
The substance use survey asked students to report how often they had driven or ridden with a driver under the influence of alcohol or drugs. Slightly fewer students reported both driving under the influence and riding with a driver under the influence than was reported in 1997. In 1999, 8.1% of students had themselves driven under the influence of alcohol or drugs, and 39.0% had ridden with a driver who was under the influence. Table 2-13 provides information on the number of times these events have occurred in the lives of the students.
Table 2-13
JUNIOR HIGH/MIDDLE SCHOOL STUDENTS 1999 Driving, and Riding with a Driver, Under the Influence of Alcohol or Drugs
Response No, never Yes - 1 or 2 times - 3 to 5 times - 6 to 9 times - 10 to 19 times - 20 to 39 times - 40 or more times Total Driven Under the Influence 89.1% 4.2% 1.6% 0.7% 0.6% 0.1% 1.0% 8.1% Ridden with Influenced Driver 57.1% 15.7% 6.9% 4.2% 3.7% 2.3% 6.3% 39.0%
Substance Abuse in Arizona: 1999
29
Differences in Attitudes between Students That Do/Do Not Use Substances
Table 2-14 presents the attitudes of students toward substance use broken down by those who use or do not use a substance. For example, among students who have smoked before, 8.3% reported they approve of cigarette use. Over 20% of students who have smoked cigarettes before report they disapprove of smoking. In general, whether or not they have ever smoked, students were more likely to approve of smoking in 1999 than they were in 1997. Among students who have used alcohol, reported attitudes toward alcohol use have changed little since 1997: slightly more students who have never used alcohol approve of its use by their peers.
Table 2-14
JUNIOR HIGH/MIDDLE SCHOOL STUDENTS 1999 Comparison Between Attitudes Toward Peer Substance Use and Related Behaviors and Own Same Behaviors (Ever in Life)
Substance/ Behavior Cigarettes Smokeless Tobacco Alcohol Own Use/ Behavior Yes No Yes No Yes No Approve 8.3% 7.8% 14.8% 6.9% 11.5% 8.2% Do Not Care (No Opinion) 25.3% 12.0% 27.0% 16.1% 24.5% 10.8% Do Not Mind (Own Choice) 45.4% 28.6% 39.9% 28.7% 43.9% 24.7% Disapprove 21.1% 51.6% 18.3% 48.4% 20.1% 56.3%
Relationship Between Substance Use and Selected Factors
This section contains information regarding the extent of substance use of junior high school students by school achievement and participation in extracurricular activities. Again, causal conclusions should not be drawn from the presented findings. The magnitude of any apparent differences between groups requires careful consideration and analysis that exceeds the scope of this report.
School Achievement
This section examines the impact of self-reported grades on substance use. Table 2-15 shows that of all students, regardless of drug use history, 56.5% reported they made either all A's, all B's, or some combination of A's and B's. It is significant to note the low percentage of students who reported in the "D's and F's" category. When comparing these variables with uncommonly used substances, such as depressants or steroids, their impact requires cautious interpretation.
30
Substance Abuse in Arizona: 1999
Table 2-15
JUNIOR HIGH/MIDDLE SCHOOL STUDENTS 1999 Self Reported Grades
Grades All or Mostly A's Mostly A's and B's All or Mostly B's Mostly B's and C's All or Mostly C's Mostly C's and D's All or Mostly D's Mostly D's and F's All or Mostly F's Percentage 16.1% 30.6% 9.8% 22.1% 6.8% 8.4% 1.2% 3.4% 1.7%
Table 2-16 shows that the relationship between school achievement and substance use generally follows a pattern: levels of substance use generally increase as the level of achievement decreases. Unlike the correlation between grades and high school student substance use, most junior high school substance use increases are particularly large between grades, such as the increase between cigarette use, which rises from 25.3% among students making A's to 64.0% of students making D's and F's. Cocaine use rises from 3.1% of students receiving all A's to 17.1% of students receiving D's and F's. Methamphetamine use is also much higher for individuals with D's and F's (16.1%) as opposed to students receiving A's (3.3%).
Table 2-16
JUNIOR HIGH/MIDDLE SCHOOL STUDENTS 1999 Substance Use Ever in Life: Self Reported Grade Comparison
Substance Cigarettes Smokeless Tobacco Alcohol Marijuana Cocaine Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids A's 25.3% 7.2% 35.6% 13.4% 3.1% 3.3% 3.1% 8.5% 4.0% 2.8% 3.3% A's & B' s 32.3% 6.3% 41.5% 15.1% 2.7% 2.8% 3.1% 13.5% 3.3% 2.5% 2.4% B's 40.3% 7.3% 52.1% 24.2% 4.2% 3.6% 3.3% 17.0% 5.8% 3.0% 2.4% B's & C's 45.9% 9.3% 57.4% 24.1% 5.6% 4.3% 5.2% 20.4% 5.9% 4.2% 3.6% C's 51.6% 18.8% 60.7% 31.9% 7.0% 7.9% 5.7% 27.1% 8.3% 6.6% 5.7% C's & D's 50.3% 10.6% 56.4% 31.0% 6.0% 7.7% 8.5% 23.6% 8.1% 9.5% 6.3% D's & F's 64.0% 19.5% 64.5% 43.1% 17.1% 16.1% 15.6% 36.0% 15.6% 16.6% 14.7%
5
5
The "D's and F's" column includes students who reported they received D's, D's and F's, or all F's. These three categories were collapsed to provide a more reliable analysis. The actual number of students who reported these grades and used substances were insufficient to provide a valid conclusion individually. 31
Substance Abuse in Arizona: 1999
Participation in Extracurricular Activities
It has been suggested that if students had other activities in which to participate or an after-school job, they would be less likely to engage in unhealthy and/or dangerous habits such as substance use. Table 2-17 shows that of all junior high school students surveyed, 60.2% participated in school related activities, 49.3% participated in outside school activities and 19.1% were employed. This examines the possible relationship between substance use and extracurricular activities.
Table 2-17
JUNIOR HIGH/MIDDLE SCHOOL STUDENTS 1999 Participation in Extracurricular Activities
Participation Yes No School Activities 60.2% 39.8% Outside School Activities 49.3% 50.7% Employment 19.1% 80.9%
Table 2-18 presents the comparison of use among students involved in extracurricular activities and/or employed and those students who do not participate in extracurricular activities and/or are unemployed. Overall, both types of extracurricular activities yielded similar patterns, with lower levels of use apparent among students who participated in after school or outside-of-school extracurricular activities. Employed students report higher levels of lifetime use for all substances.
Table 2-18
JUNIOR HIGH/MIDDLE SCHOOL STUDENTS 1999 Substance Use Ever in Life: Extracurricular Activity and Employment Participation Comparison
School Activities Substance Cigarettes Smokeless Tobacco Alcohol Marijuana Cocaine Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids Yes 38.2% 8.1% 48.5% 19.1% 3.8% 4.0% 4.3% 16.5% 4.8% 3.9% 3.4% No 42.5% 11.1% 50.4% 26.5% 7.0% 6.6% 6.1% 20.0% 7.2% 6.1% 5.2% Outside School Activities Yes No 38.3% 8.2% 48.4% 19.5% 4.2% 4.3% 4.9% 16.3% 5.4% 4.6% 4.1% 41.5% 10.2% 50.2% 24.4% 5.9% 5.6% 5.2% 19.1% 6.0% 4.9% 4.1% Employment Yes 50.5% 15.5% 60.1% 33.1% 10.3% 10.9% 10.0% 27.8% 12.8% 11.4% 10.9% No 37.4% 7.7% 46.6% 19.4% 3.9% 3.6% 4.0% 15.5% 4.1% 3.3% 2.6%
32
Substance Abuse in Arizona: 1999
Conclusions
This in-depth review of substance abuse by junior high school students reveals that: Most substance use among junior high school students is remaining constant. In terms of most lifetime, monthly, and weekly use, junior high school students have either decreased or maintained their levels of use. Female junior high school students are using substances at similar rates to male students. Those junior high school students who make better grades tend to use substances less freque ntly than those students who make lower grades. Students who participate in extracurricular activities tend to use substances less frequently than students who do not participate.
Substance Abuse in Arizona: 1999
33
34
Substance Abuse in Arizona: 1999
HIGH SCHOOL STUDENTS
Introduction
This survey was conducted across the state using a sample of students rather than the entire student population, but is representative of the entire student population. In 1999, a total of 4,588 public high school students across the state participated in the substance use survey. The sex, race, and grade distributions presented here are representative of the state student population. The sex breakdown of the 1999 high school sample is as follows: 49.7% females and 50.3% males. These figures are almost identical to the state's population of high school students. Differences in the results on the basis of sex are unlikely due to the make up of the sample. The racial make-up of the high school sample was also similar to the racial breakdown of Arizona high school students. The racial breakdown is as follows: 58.4% White (not Hispanic), 21.3% Hispanic, 9.6% American Indian, 1.9% Asian, 2.5% Black (not Hispanic), and 6.3% Other. White students were not oversampled, and an accurate racial breakdown of high school students is reflected. It can therefore be assumed that any differences in the survey results will not be due to the racial make up of the sample. The grade ranges represented in the sample are evenly distributed, with a gradual decline in the percentages as grade level increases. The 1999 high school sample contains 26.5% ninth graders, 26.3% tenth graders, 23.5% eleventh graders, and 20.3% twelfth graders. These proportions are consistent with the state's grade breakdown of high school students. Differences in the results of the survey on the basis of grade are assumed to be due to the distinct behaviors of the grade level rather than the make up of the sample.
Prevalence of Substance Use: Ever in Life, Last Month and Last Week
According to the 1999 survey results, alcohol and cigarettes are the most frequently used substances among high school students (see Table 3-1). Marijuana is the third most commonly used substance across all three temporal measures. Over three quarters of surveyed high school students reported trying alcohol, 62.6% reported trying cigarettes and 49.5% reported trying marijuana. Approximately one-fifth of these students report trying inhalants and smokeless tobacco, but their monthly and weekly use reported drops more sharply than any of the other surveyed substances. Approximately nineteen percent report trying hallucinogens, and 12.6% report trying amphetamines/methamphetamines. Just under 15% report using cocaine, less than 10 % report using depressants and 10.2% report use of narcotics. Steroids have been used b y 4.1% of the surveyed students, an increase of 63% over the 1997 rate.
Substance Abuse in Arizona: 1999
35
Table 3-1
HIGH SCHOOL STUDENTS 1999 Substance Use: Ever in Life, In the Last Month and In the Last Week
Substance Cigarettes Smokeless Tobacco Alcohol Marijuana Cocaine Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids Ever in Life 62.6% 22.3% 77.6% 49.5% 14.2% 12.6% 9.6% 21.1% 18.6% 10.2% 4.1% In Last Month 26.1% 6.7% 45.4% 24.7% 5.4% 4.8% 4.7% 5.5% 8.6% 4.8% 2.4% In Last Week 19.8% 3.7% 26.9% 18.0% 3.2% 3.0% 3.4% 3.6% 5.0% 3.4% 2.1%
Except for alcohol use, less than 50% of students who have tried individual substances in their lifetime report using in the last month. Close to 60% of those who have tried alcohol report doing so within the last month. Overall, while the differences in percentages between high school students who have used in the last month and those who have used in the last week are considerably smaller, the proportion of students who reported they have used alcohol in the last week is approximately half the proportion of students who have used in the last month.
Comparison to 1997 High School Substance Use Rates
The rates presented above do not indicate whether substance use is increasing or decreasing, but comparison of the 1997 rates to those in 1999 helps in determining substance use trends among Arizona high school students. In comparing the 1999 survey results to the 1997 results, it is found that among all students who have used (in their lifetime, in the last month and/or in the last week): Cigarette, smokeless tobacco and methamphetamine use is lower than in 1997; Alcohol, cocaine, inhalant, narcotic and steroid use is higher; and Marijuana, depressant and hallucinogen use has not changed. A more in-depth discussion of these trends is presented later in this chapter.
Comparison to 1998 National Data of High School Seniors
To compare substance use rates in Arizona with national rates, data for Arizona high school seniors (class of 1999) was compared with national high school data from the Monitoring the Future survey. (See Table 3 -2.) Comparisons show that: The proportions of Arizona seniors who have smoked cigarettes or had an alcoholic drink are comparable to other seniors across the nation.
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Substance Abuse in Arizona: 1999
Arizona seniors have used steroids, inhalants, marijuana and cocaine at higher rates than the national data reports. Further, Arizona seniors have a much higher cocaine rate, at twice the national rate. Fewer Arizona seniors are smoking on a monthly basis than their counterparts nationwide. This may be due to the strong presence of the anti-smoking campaign such as the Tobacco Education Prevention Program. Arizona seniors use marijuana, inhalants and steroids at higher rates than reported in the national survey. Monthly cocaine use is t ice as prevalent in Arizona as w across the nation. COMPARISON BETWEEN NATIONAL AND ARIZONA HIGH SCHOOL SENIORS Substance Use: Ever in Life and In the Last Month
Ever in Life Nation6 Arizona Cigarettes Smokeless Tobacco Alcohol Marijuana/Hashish Cocaine (not Crack) Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids 65.3% N/A 81.4% 49.1% 9.3% N/A N/A 15.2% N/A N/A 2.7% 66.9% 29.6% 84.4% 57.9% 18.1% 15.5% 11.2% 18.6% 24.9% 12.4% 3.8% In Last Month Nation Arizona 35.1% N/A 52.0% 22.8% 2.5% N/A N/A 2.3% N/A N/A 1.1% 13.9% 8.8% 53.7% 27.8% 5.5% 5.6% 5.9% 5.6% 10.2% 5.9% 3.2%
Table 3-2
Trends Among High School Students in Arizona: 1991 to 1999
A comparison of public high school students' use from 1991 to 1999 reveals that use levels for most substances (for which data are available) have fluctuated. Tables 3-3, 34, and 3-5 show this is true for all three temporal measures of use: ever in life, in the last month and in the last week. However, because substance use may be higher among students who have ever tried a substance in their lives, continued use (such as on a monthly or weekly basis), may not have increased. In some instances, the increased proportion of students trying a substance but not using it regularly shows that students have made a decision to not use the substance after they have tried it, which is a positive result.
6
Snyder, Howard N., and Sickmund, Melissa. (1999). Juvenile offenders and victims: 1999 National Report. Washington, DC: Office of Juvenile Justice and Delinquency Prevention. Graph shown is a portion of a table adapted by these authors based upon the Monitoring the Future Survey of 1998. 37
Substance Abuse in Arizona: 1999
Table 3-3
HIGH SCHOOL STUDENTS Substance Use Ever in Life: 1991-1999 Comparison7
Substance Cigarettes Smokeless Tobacco Alcohol Marijuana Cocaine Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids 1991 N/A N/A 74.9% 33.5% 9.4% 10.2% 14.9% 15.9% 12.7% 9.7% N/A 1993 N/A N/A 67.1% 36.9% 8.4% 10.1% 11.4% 19.1% 10.5% 7.8% 3.3% 1995 N/A N/A 68.8% 44.1% 10.7% 15.7% 14.4% 19.2% 15.9% 10.7% 2.8% 1997 62.7% 24.0% 74.2% 47.4% 11.6% 16.8% 11.2% 25.1% 18.1% 10.5% 2.6% 1999 62.6% 22.3% 77.6% 49.5% 14.2% 12.6% 9.6% 21.1% 18.6% 10.2% 4.1%
Note: This information is not available for cigarettes or smokeless tobacco prior to 1997.
A review of the trends of use for each substance shows that: Cigarette use is slightly lower than the 1997 figure. Smokeless tobacco use has decreased since 1997, and while monthly use is the same in 1999 as it was in 1997, these rates are lower than the rates reported in 1991-1995. Alcohol use (ever in life) has risen since 1993, but monthly and weekly use has changed little. The proportion of students who have ever used marijuana has increased, but the percent of students who use it on a weekly or monthly basis has not risen since 1997. Cocaine use has been rising in all three areas: lifetime, monthly and weekly use. Methamphetamine use in all three areas has declined between 1997 and 1999, but these rates are still higher than 1991 and 1993 rates. The percent of students who have tried depressants has decreased since its peak in 1995, but use on a monthly or weekly basis has not chanced since 1997. Inhalant use (ever in lifetime) has declined between 1997 and 1999, but is still more prevalent than it was on 1995. Hallucinogen use has not changed since 1997. Narcotic use has not changed since 1997. The percent of students who have used steroids has significantly risen, and monthly and weekly use has nearly doubled since 1997.
7
The magnitude of longitudinal changes of all substances should be interpreted carefully as small fluctuations may be due to external factors and may not be indicative of actual trends. 38
Substance Abuse in Arizona: 1999
Table 3-4
HIGH SCHOOL STUDENTS Substance Use In the Last Month: 1991-1999 Comparison
Substance Cigarettes Smokeless Tobacco Alcohol Marijuana Cocaine Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids 1991 26.6% 9.3% 42.8% 12.7% 3.3% 3.5% N/A 4.2% 5.2% N/A N/A 1993 23.3% 9.2% 34.5% 17.1% 3.1% 3.7% N/A 5.1% 3.7% N/A N/A 1995 27.4% 9.6% 37.7% 21.8% 4.5% 5.8% N/A 6.3% 6.7% N/A N/A 1997 31.3% 6.5% 43.4% 25.1% 3.8% 6.6% 4.9% 5.5% 6.4% 4.6% 1.4% 1999 26.1% 6.7% 45.4% 24.7% 5.4% 4.8% 4.7% 5.5% 8.6% 4.8% 2.4%
Note: This information is not available for depressants, narcotics or steroids prior to 1997.
Table 3-5
HIGH SCHOOL STUDENTS Substance Use In the Last Week: 1993-1999 Comparison
Substance Cigarettes Smokeless Tobacco Alcohol Marijuana Cocaine Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids 1993 N/A N/A 21.9% 12.8% 2.9% 3.1% N/A 4.0% 3.1% N/A N/A 1995 N/A N/A 23.8% 16.8% 4.5% 4.2% N/A 4.8% 5.2% N/A N/A 1997 25.3% 4.8% 23.7% 17.5% 2.2% 4.1% 3.1% 3.2% 3.3% 3.0% 1.2% 1999 19.8% 3.7% 26.9% 18.0% 3.2% 3.0% 3.4% 3.6% 5.0% 3.4% 2.1%
Note: Use in the last week was not measured prior to 1993. Also, this information is not available for cigarettes, smokeless tobacco, depressants, narcotics, or steroids prior to 1997.
Substance Abuse in Arizona: 1999
39
Age at First Use: 1999
Table 3-6 represents the age the surveyed substances were first used by high school students. For our sample of high school students, the most common age of initiation of alcohol and marijuana is between the ages of 11 and 16. The age of initiation for cigarette and inhalant use is 11 to 13 years. For the remaining substances, the 14 to 16 age range was reported as the most common age of initiation. In 1999, the age of first marijuana and alcohol use was later than the same aged students surve yed in 1997.
Table 3-6
HIGH SCHOOL STUDENTS 1999 Substance Use: Age at First Use
Substance Cigarettes Smokeless Tobacco Alcohol Marijuana Cocaine Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids 7 or younger 9.0% 12.0% 14.9% 3.7% 6.4% 7.5% 10.5% 6.5% 5.3% 7.8% 19.1% 8 - 10 20.4% 17.7% 14.2% 9.7% 4.3% 4.4% 8.3% 12.2% 4.0% 10.2% 8.0% 11 - 13 42.6% 30.2% 33.9% 41.6% 20.2% 22.7% 27.9% 46.9% 20.8% 26.6% 26.2% 14 - 16 25.8% 35.2% 33.8% 41.8% 59.1% 57.6% 47.4% 31.1% 60.5% 47.4% 43.1% 17 or older 2.1% 4.8% 3.3% 3.3% 9.9% 7.9% 6.0% 3.2% 9.4% 8.0% 8.0%
Note: This table includes only those students who report ever using each substance.
Demographic Comparisons: Students Who Have Used a Substance at Least Once in Their Lives
Before implementing a drug prevention or intervention program, it is helpful to know specifically which groups are participating in drug activities to increase the likelihood of successfully administering the program. This section describes the prevalence of substance use among those student who have used a substance at least one time in their lives, breaking this use down by sex, race, and grade. The 1999 survey revealed that substance use, which had previously been more prevalent among males than females, is becoming common to both sexes. This year's survey shows more clearly the closing of the gender gap. Table 3-7 shows that: Females tend to use cigarettes, alcohol, marijuana, cocaine, methamphetamine, depressants, inhalants and narcotics at the same pace as their male counterparts. The largest difference between male and female use occurs in smokeless tobacco, hallucinogen and steroid use-- all of which are used more often among males.
40
Substance Abuse in Arizona: 1999
Table 3-7
HIGH SCHOOL STUDENTS 1999 Substance Use Ever in Life: Sex Comparison
Substance Cigarettes Smokeless Tobacco Alcohol Marijuana Cocaine Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids Female 63.2% 12.3% 79.1% 47.4% 12.8% 13.0% 9.3% 21.2% 15.7% 8.9% 2.2% Male 62.7% 31.9% 77.4% 51.8% 15.2% 12.1% 9.6% 20.7% 21.0% 11.5% 5.5%
A review of drug use among students of different races, Table 3-8 shows that American Indian students have the highest rate of substance use for six substances: cigarettes, smokeless tobacco, marijuana, cocaine, inhalants and narcotics. Black students have the highest steroid use rate, and also high rates of marijuana and depressant use. Students who identify themselves as an "other" racial identity tend to have the highest levels of hallucinogen use, and high levels of cocaine, methamphetamine, depressant and inhalant use. Alcohol use is about the same for all racial identities except for Asian students, who have lower rates of use. For all substances, White or Hispanic students had a comparable or lower rate of substance use than their counterparts.
Table 3-8
HIGH SCHOOL STUDENTS 1999 Substance Use Ever in Life: Race Comparison
Substance Cigarettes Smokeless Tobacco Alcohol Marijuana Cocaine Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids White 59.6% 22.4% 76.2% 44.1% 9.4% 12.1% 8.9% 17.0% 17.2% 8.9% 3.3% Black 60.0% 21.8% 80.0% 63.6% 20.9% 14.5% 12.7% 26.4% 19.1% 17.3% 15.5% Hispanic 64.1% 15.0% 83.1% 52.5% 17.6% 10.8% 8.5% 24.1% 15.7% 7.8% 2.9% American Indian 78.3% 36.9% 78.7% 69.7% 26.7% 13.0% 10.2% 31.0% 13.0% 13.0% 3.3% Asian 53.0% 26.5% 69.9% 43.4% 14.5% 15.7% 10.8% 22.9% 21.7% 16.9% 14.5% Other 68.7% 25.1% 80.4% 57.5% 21.5% 21.1% 17.1% 30.9% 30.9% 20.0% 9.5%
Substance Abuse in Arizona: 1999
41
The data demonstrates that substance use increases as students progress through high school. However, there are three exceptions. First, steroid use does not change between grades, which indicates that those students who use steroids begin doing so in their freshman year or sooner and continue to use throughout their high school career. Second, there is a decrease in narcotics use in the eleventh grade in comparison to other grades. In 1997, 9.8% of ninth graders (who would be eleventh graders in 1999) reported using narcotics. Finally, inhalant use is more prevalent among ninth and tenth graders than among eleventh and twelfth graders. This indicates that inhalant use was more of a younger student's drug; although overall, the rate of inhalant use is not changing. The prevalence of ever in life substance use is presented by grade in Table 3-9.
Table 3-9
HIGH SCHOOL STUDENTS 1999 Substance Use Ever in Life: Grade Comparison
Substance Cigarettes Smokeless Tobacco Alcohol Marijuana Cocaine Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids Ninth 60.0% 17.1% 72.9% 42.7% 10.4% 9.5% 8.6% 24.1% 13.2% 9.2% 4.0% Tenth 61.7% 19.6% 76.6% 47.0% 12.1% 10.8% 8.9% 20.2% 16.4% 9.4% 3.7% Eleventh 65.5% 24.1% 81.4% 54.8% 16.0% 13.7% 8.6% 19.5% 20.2% 8.5% 3.7% Twelfth 66.9% 29.6% 84.4% 57.9% 18.1% 15.5% 11.2% 18.6% 24.9% 12.4% 3.8%
Substance Use While on School Grounds
The Substance Use and Public School Students survey not only asks students about their own use patterns, but asks about their attitudes toward substance use in general. This section presents the survey results examining substance use and school attendance.
Attending School Under the Influence of Alcohol or Drugs
In 1999, fewer students reported they had ever attended school under the influence of drugs than was reported in 1997. This year, less than one third (31.6%) of students reported coming to school under the influence of alcohol or drugs. This is less than the 33.4% of students who reported the same behavior in 1997. The percentage of students who reported they had used drugs or alcohol before, but had never attended school under the influence is higher than what was reported in 1997. This indicates that
42
Substance Abuse in Arizona: 1999
although students are still using, they are less likely to carry these behaviors into the school setting than in 1997. Please see Table 3 -10.
Table 3-10
HIGH SCHOOL STUDENTS 1999 Attending School Under the Influence of Alcohol or Drugs
Use of Alcohol or Drugs Have Never Used Have Used, But Have Never Attended School Under the Influence Have Attended School Under the Influence: - 1 or 2 times - 3 to 5 times - 6 to 9 times - 10 to 19 times - 20 to 39 times - 40 or more times Total Percentage 27.5% 39.1%
9.9% 4.6% 3.0% 3.5% 2.7% 7.9% 31.6%
Student Use of Drugs or Alcohol at School
When comparing the percent of students who atte nd school under the influence of alcohol or drugs to the percent of students who actually use while on school grounds, it appears that nearly as many students use substances while on campus (24.8%). Almost 5% of surveyed high school students report using alcohol or drugs at school forty or more times in their lives. See Table 3-11.
Table 3-11
HIGH SCHOOL STUDENTS 1999 Use of Alcohol or Drugs at School (Ever in Life)
Use of Alcohol or Drugs Have Never Used Have Used, But Have Never Used at School During Regular School Hours Have Used at School During Regular School Hours: - 1 or 2 times - 3 to 5 times - 6 to 9 times - 10 to 19 times - 20 to 39 times - 40 or more times - Total Percentage 28.2% 45.2%
9.3% 3.8% 2.4% 2.8% 2.4% 4.1% 24.8%
Substance Abuse in Arizona: 1999
43
Attitudes and Perceptions Concerning Substance Use
Attitudes and perceptions about drug use drive overall substance consumption patterns. This section examines attitudes about both self-reported and peer substance use and related behaviors, with a comparison of attitudes toward peer behaviors by students who have participated in the same behaviors.
Perceived Effect of Substance Use on Social Life and Attitude Toward School
The 1999 survey results indicate that approximately two-thirds of high school students who have used alcohol or drugs believe their use has not affected their social lives. Three quarters of those who have used report no effect of their use on their attitude toward school. Of those students who report some type of effect on their social life, it appears that twice as many report positive versus negative effects. With regard to effect on attitude toward school, those affected report similar proportions of positive and negative influence. These results are unchanged in comparison to 1997 figures, and are shown in Table 3-12.
Table 3-12
HIGH SCHOOL STUDENTS 1999 Effect of Self Use of Alcohol or Drugs on Social Life and Attitude Toward School
Effect Very Positive Positive Negative Very Negative No Effect Social Life 7.9% 14.0% 6.8% 3.1% 68.2% Attitude Toward School 5.3% 6.3% 10.1% 3.4% 74.9%
Note: Only those students who have ever used alcohol or drugs are represented in this table.
Attitudes Concerning Peer Substance Use and Related Behaviors
Students were asked how they felt about someone their age using tobacco, alcohol and drugs. As the figures in Table 3-13 show, students tend to disapprove of substance use more often than approve of it. For example, more students think that smoking cigarettes, which is common among the high school population, is unacceptable; only 4.2% of students approve of its use in comparison to 32.0% who disapprove. Alcohol, another popular substance, produces much the same attitudes as cigarette use, but more students (11.1%) approve of its use. Disapproval of drug use and smokeless tobacco is the most common attitude toward these substances. More than two thirds of high school students disapprove of driving under the influence of alcohol, and threefourths of high school students disapprove of driving under the influence of drugs. In general, a higher percentage of students reported an attitude of disapproval for all substances in 1999 than was reported by students in 1997.
44
Substance Abuse in Arizona: 1999
However, because high school students disagree with substance use does not necessarily mean that the respondent hasn't personally used substances. A comparison between substance use attitudes and self-reported use is explored in a later section of this report.
Table 3-13
HIGH SCHOOL STUDENTS 1999 Attitudes Toward Peer Substance Use and Related Behaviors
Substance/Behavior Cigarettes Smokeless Tobacco Alcohol Drugs DUI: Alcohol DUI: Drugs Approve 4.2% 3.6% 11.1% 5.1% 3.4% 3.7% Do Not Care (No Opinion) 17.9% 18.4% 18.4% 15.2% 6.1% 9.2% Do Not Mind (Own Choice) 45.9% 38.6% 48.1% 36.8% 9.8% 13.5% Disapprove 32.0% 39.4% 22.4% 42.9% 80.8% 73.6%
Driving Under the Influence of Alcohol or Drugs
The substance use survey also asked students to report how often they had driven or ridden with a driver under the influence of alcohol or drugs. Slightly more students reported both driving under the influence and riding with a driver under the influence than was reported in 1997. In 1999, 25.3% of students had themselves driven under the influence of alcohol or drugs, and 61.7% had ridden with a driver who was under the influence. Refer to Table 3-14 for more information on the number of times these events occurred in the lives of the students.
Table 3-14
HIGH SCHOOL STUDENTS 1999 Driving, and Riding with a Driver, Under the Influence of Alcohol or Drugs
Response No, never Yes - 1 or 2 times - 3 to 5 times - 6 to 9 times - 10 to 19 times - 20 to 39 times - 40 or more times Total Driven Under the Influence 72.9% 9.5% 4.9% 2.7% 2.1% 1.5% 4.7% 25.3% Ridden with Driver Under the Influence 35.7% 17.7% 10.8% 6.6% 6.8% 5.3% 14.4% 61.7%
Substance Abuse in Arizona: 1999
45
Differences in Attitudes Between Students That Do/Do Not Use Substances
Table 3-15 represents the attitudes of students toward substance use broken down by those who use or do not use a substance. For example, among students who have smoked before, 5.4% reported they approve of cigarette use. 20.7% of students who have smoked cigarettes before do not approve of smoking. In general, whether or not they have ever smoked, students were less likely to approve of smoking in 1999 than they were in 1997. More students tended to approve of smokeless tobacco use in 1999 than in 1997, whether or not they have used it before. Attitudes toward alcohol use have changed little since 1997, although slightly more students who have never used alcohol approve of its use by their peers.
Table 3-15
HIGH SCHOOL STUDENTS 1999 Comparison Between Attitudes Toward Peer Substance Use and Related Behaviors and Own Same Behaviors (Ever in Life)
Substance/ Behavior Cigarettes Smokeless Tobacco Alcohol Own Use/ Behavior Yes No Yes No Yes No Approve 5.4% 2.2% 9.4% 2.9% 13.1% 3.9% Do Not Care (No Opinion) 20.9% 12.6% 28.1% 15.7% 20.2% 11.0% Do Not Mind (Own Choice) 53.1% 33.6% 44.7% 45.2% 52.9% 31.3% Disapprove 20.7% 51.6% 17.9% 36.3% 13.8% 53.9%
* Due to the structure of the survey questions, these "own behaviors" include driving under the influence of either or both alcohol or drugs (i.e., these substances are not separated in the "own DUI behavior" question - see copy of survey in Appendix B).
Relationship Between Substance Use and Selected Factors
This section contains information regarding the extent of substance use of high school students by school achievement, and participation in extracurricular activities. Causal conclusions should not be drawn from the presented findings. The magnitudes of any apparent differences between groups warrant careful consideration and analysis that exceeds the scope of this report.
School Achievement
This section examines the impact of self-reported substance abuse by grade level. To begin, Table 3-16 shows that of all students, regardless of drug use history, 54.3% reported they made either all A's, all B's, or some combination of A's and B's. Please note that there are a low percentage of students who reported in the "D's and F's" category.
46
Substance Abuse in Arizona: 1999
Table 3-16
HIGH SCHOOL STUDENTS 1999 Self Reported Grades
Grades All or Mostly A's Mostly A's and B's All or Mostly B's Mostly B's and C's All or Mostly C's Mostly C's and D's All or Mostly D's Mostly D's and F's All or Mostly F's Percentage 16.5% 28.1% 9.7% 24.2% 7.1% 9.0% 1.7% 2.4% 1.2%
Table 3-17 indicates that the relationship between school achievement and substance use is such that levels of substance use generally increase as the level of achievement decreases. Some increases are particularly large, such as the increase between marijuana use, which rises from 27.7% of student making A's to 77.7% of students making D's and F's. Narcotic use rises from 7.9% of students receiving all A's to 26.9% of students receiving D's and F's. Inhalant use is also much higher for individuals with D's and F's (40.3%) as opposed to students receiving A's (13.8%).
Table 3-17
HIGH SCHOOL STUDENTS 1999 Substance Use Ever in Life: Self Reported Grade Comparison
Substance A's A's and B's 55.8% 17.6% 75.0% 41.6% 8.9% 9.0% 6.3% 16.2% 13.6% 7.7% 2.3% B's B's and C's 70.2% 26.0% 83.7% 55.8% 15.9% 13.3% 10.0% 21.8% 20.0% 10.9% 3.5% C's C's and D's 80.2% 27.3% 88.3% 71.5% 21.8% 15.8% 10.5% 29.8% 27.3% 11.5% 4.0% D's and F's8 83.6% 37.4% 88.7% 77.7% 35.3% 27.3% 22.3% 40.3% 37.0% 26.9% 11.8%
Cigarettes Smokeless Tobacco Alcohol Marijuana Cocaine Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids
8
40.2% 16.8% 59.9% 27.7% 9.5% 11.4% 7.8% 13.8% 11.9% 7.9% 5.3%
67.6% 19.0% 82.2% 49.3% 10.4% 10.2% 10.4% 20.1% 16.4% 6.7% 2.3%
72.7% 30.5% 88.6% 63.5% 18.7% 14.9% 13.3% 29.2% 26.3% 12.7% 5.7%
The "D's and F's" column includes students who reported they received D's, D's and F's, or all F's. These three categories were collapsed to provide a more reliable analysis. The actual number of students who reported these grades and used substances were insufficient to provide a valid conclusion individually. 47
Substance Abuse in Arizona: 1999
Participation in Extracurricular Activities
It has been postulated that if students had other activities in which to participate or an after-school job, they would be less inclined toward unhealthy or dangerous habits such as substance use. Table 3-18 shows that of all high school students surveyed, 63.1% participate in school related activities, 56.7% participate in outside school activities, and 42.5% are employed. This section will examine the relationship between substance use and extracurricular activities.
Table 3-18
HIGH SCHOOL STUDENTS 1999 Participation in Extracurricular Activities and Employment
Participation Yes No School Activities 63.1% 36.9% Out-of-School Activities 56.7% 43.3% Employment 42.5% 57.7%
Table 3-19 presents the comparison of use among students involved in extracurricular activities and/or employed and those students who do not participate in extracurricular activities and/or are unemployed. Overall, both types of extracurricular activities yielded similar patterns, with considerably lower levels of drug use among those students who participate in either at-school or outside-of-school extracurricular activities. For both types of extracurricular activity, steroids are the only substances used more frequently among students participating in activities than students who are not involved in extracurricular activities. In terms of employment and substance use, employed students report higher levels of lifetime use for all substances.
Table 3-19
HIGH SCHOOL STUDENTS 1999 Substance Use Ever in Life: Extracurricular Activity and Employment Participation Comparison
Substance Cigarettes Smokeless Tobacco Alcohol Marijuana Cocaine Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids
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School Activities Yes No 58.2% 70.8% 21.9% 23.3% 74.9% 84.1% 42.7% 61.8% 10.3% 20.7% 9.7% 17.6% 7.9% 12.4% 17.7% 26.7% 14.4% 25.5% 7.8% 14.4% 4.3% 3.5%
Out-of-School Activities Yes No 57.1% 70.5% 21.1% 24.1% 74.9% 82.6% 42.8% 58.7% 10.5% 18.8% 10.6% 15.1% 7.9% 11.7% 17.5% 25.5% 14.8% 23.5% 7.8% 13.3% 4.2% 3.6%
Employment Yes No 67.0% 59.8% 28.1% 18.3% 83.7% 74.2% 56.0% 45.0% 17.4% 11.8% 16.5% 9.8% 12.1% 7.8% 22.1% 20.1% 24.0% 14.7% 12.8% 8.2% 5.7% 2.8%
Substance Abuse in Arizona: 1999
Conclusions
This in-depth review of reported high school substance use, reveals the following: Not all substance use among high school students is increasing. About half of the substa nce behaviors in the 1999 survey decreased. High school seniors in Arizona use marijuana, cocaine and inhalants at higher rates than high school seniors across the country. Cocaine use continues to rise in terms of lifetime, monthly and weekly use among high school students. Females are using substances at similar rates to males. Students who make better grades use substances less frequently than those who make lower grades in their classes. With the exception of steroid use, students who participate in ext racurricular activities tend to use substances less frequently than students who do not participate. Students who are employed tend to use substances more often that those students who are not employed.
Substance Abuse in Arizona: 1999
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Substance Abuse in Arizona: 1999
ADULT PROBATIONER SUBSTANCE USE
In the spring of 2000, staff from the Arizona Criminal Justice Commission met with probation officers throughout the state to discuss drug use among probationers. Most of these probation officers were supervising adult offenders. There were a few who supervise juvenile offenders. In all, twenty probation officers from thirteen counties met with Commission staff for one of three group interviews. Their views are the focus of this chapter. The Drug Treatment Education Fund (DTEF) coordinators in the county probation offices across the state work with drug cases and other offenses. However, most cases involve drug use even if the charge was not drug-related. According to Navajo County Probation Department records, 63% of probationers' (adult and juvenile) cases involved substance abuse, even though they may not have been charged with a drug offense. In the same county, 94% of justice court cases are connected to substance abuse, either directly or indirectly. Many of the probation officers interviewed stated that probationers address their issues through the use of drugs and avoid dealing with the root of their problems. The probation officers indicated that most clients really don't want to do drugs, but resort to use because it is easier than dealing with the issues that cause them pain. The probation officers advised that the process of probation is somewhat analogous to surgery: the probationer must be "cut open" and the problem removed before they can begin to heal. This requires a variety of services that may include getting a high school equivalency diploma, attending counseling, participating in residential treatment or intensive probation. Services currently available to probationers and services needed by probation departments to better assist probationers will be discussed in this chapter.
Introduction
According to the collective experiences of the officers interviewed, the "average" probationer in Arizona is male and between 25 and 35 years of age, although some areas such as Bisbee have an older probation population that is proportionate to the general population. This mirrors the findings of the United States Department of Justice Office of Justice Programs that show most probationers to be between the ages of 25 and 34 years of age9. Probationers are usually of a lower socioeconomic status than the general population, and are frequently unemployed. In Bisbee, probationers are often marginally or self-employed. When probationers are employed, usually in a trade occupation, they tend to have a poor employment history a nd poor job skills. In southern areas of the state, namely Santa Cruz County, Willcox, Safford, Elfrida, Douglas and Marana, probationers may hold seasonal (temporary) employment.
9
United States Department of Justice; Office of Justice Programs; Bureau of Justice Statistics. March 1998. Special Report: Substance Abuse and Treatment of Adults on Probation, 1995. 51
Substance Abuse in Arizona: 1999
According to the group interviews with the probation officers, the average probationer has an underreported history of poly-substance abuse. Their impulse control is poor, and they have trouble delaying gratification. In other terms, probationers tend to act on impulse without thinking consequences through; they tend to pursue immediate, shortterm gratification, without concern for long -term effects. The family lives of probationers show a general lack of social support. Probationers tend to be single rather than married. When in a relationship, they typically have poor relations with their partners. The family history of the typical probationer includes not only a poor social support but an array of abuses, including domestic violence, child abuse, and family substance abuse. Typically, there is an intergenerational criminal history in the family according to the probation officers. One probation officer indicated that in his county many male probationers tend to reside with parents/grandparents. Given the current home situation of probationers, they often revert to old behaviors after completing probation. Probationers are usually less educated than the general population. Across Arizona, most probationers have a ninth grade education, dropping out after the freshman year of high school. In Pima County, 44% of probationers ha ve not completed high school. 10 In Maricopa County, the average probationer has not completed the tenth grade. Nationally, 30.2% of adult probationers have not completed high school. 11 Many probationers have learning disabilities and/or mental health issues. The criminal justice history of a probationer can start as young as eight years of age, and doesn't necessarily begin with drug offenses. According to the probation officers interviewed, if probationers are not on probation for a drug -related offense, most are on probation for drug-related crimes 12. On average, probationers in Arizona have seven years of involvement in the criminal justice system. Drug use begins as a juvenile, so by the time the probationer begins their probation they already have a twelve year history of drug abuse that began with alcohol and marijuana use. The probation officers interviewed reported that drug crime is increasing annually. For this reason, a look at probationers' drugs of choice may provide insight into drug crime patterns in Arizona.
Probationer Drugs of Choice
The probation officers interviewed strongly agreed that alcohol, marijuana, methamphetamine and cocaine were the most abused drugs among probationers in their counties. While this is generally true across Arizona , these four drugs are in no particular order; methamphetamine may be the drug of choice in one area while cocaine is the drug of choice in another area.
10
Superior Court of Arizona in Pima County (1999). Adult Probation Department of the Arizona Superior Court in Pima County: Probation: An Excellent Return on Investments. 1999 Annual Report. Tucson, AZ. 11 United States Department of Justice; Office of Justice Programs; Bureau of Justice Statistics (1998). Substance Abuse and Treatment of Adults on Probation, 1995. 12 Drug-related crimes are those crimes that help to support/fund continued drug use. 52
Substance Abuse in Arizona: 1999
Chemically, the probationer drugs of choice result in acute behavior that is criminal in nature.13 Looking at the most common substances used among public school students we can predict the same drugs to remain common and the same behaviors to be manifested among probationers as today's students become adults. Table 4-1 provides a list of areas highly affected by these substances according to the probation officers interviewed. This table is based solely upon the participation of the probation officers interviewed and does not necessarily indicate that drug use may be more prevalent in one county than in a nother. There are two other common substances that, while not agreed upon by all officers across the state, are in need of mention: designer drugs 14 and heroin. Yuma County and some areas of central and northern Arizona have reported an increase in heroin use. Pima County, Sedona and NAU were reported to have increased use in designer/rape drugs.
Table 4-1
PROBATIONERS Areas Highly Affected by Each Drug
(Based Upon the Opinions of the Probation Officers Interviewed) Cochise County, especially Douglas area Gila County Graham County Cocaine Bisbee and Douglas areas of Cochise County Casa Grande and Coolidge areas of Pinal County Santa Cruz County Marijuana Bisbee and Douglas areas of Cochise County Graham County Santa Cruz County Yuma County Methamphetamine Amado area, between Pima and Santa Cruz Counties Cochise County Areas of Mammoth, Oracle, and San Manuel in Pinal County Maricopa County Northern Arizona Counties 15 Pima County Yuma County Alcohol
The probation officers provide some insight as to why these drugs are the drugs of choice. Many drugs are common in an area because of occupational and economic factors. For example, probation officers working in the areas near some interstates
13 14
Personal interview with Vince Carolan, Adult Services Division; Administrative Office of the Courts. The Office of National Drug Control Policy defined "designer drugs" on page 21 of the National Drug Control Strategy: 2000 Report as "a substance on the illegal market that is a chemical analogue or variation of another psychoactive drug". 15 Probation officers in the northern counties reported that the great majority of drug related cases they see involve the use of methamphetamine, although marijuana is still common as well. 53
Substance Abuse in Arizona: 1999
reported that methamphetamine use is high among some employment groups, such as truck drivers because it is sometimes used to keep them awake. Several other probation officers reported that as cocaine becomes more affordable, cocaine users are now often part of the middle class. Just as some areas are experiencing an increase in some substance use, other areas are witnessing a decrease in some substance use. For example, Coconino County has been experiencing a decrease in methamphetamine use. Often, when use of a certain substance drops in an area, the use of another drug increases, but this is not the case in Coconino County. The county cannot yet conclude why this drop has occurred because there has yet to be another drug (called a replacement drug) to take its place.
Assessment of Probationers
At intake, all new probationers are assessed to determine their: (1) risk for reoffending; and (2) level of need for services. 16 The Adult Substance Use Survey (ASUS) is the tool adopted from the state of Colorado that is used to collect this information both at intake (and upon exiting the program) to determine treatment needs of the individual probationer. Also upon intake, a social history is obtained. Higher risk probationers may be assessed further using additional instruments. Probation officers then use these scores and history information to determine the types of services needed by the probationer. Upon exiting the program, the ASUS scores indicate whether or not probation helped the probationer's behavior.
Services Available to Probationers
Once the needs of the probationer are assessed, they are compared with the services available to the probation officer in assisting their probationers. Table 4-2 provides a description of the services probation departments may provide to probationers.
16 Arizona Supreme Court; Administrative Office of the Courts; Adult Services Division. March 1999. Drug Treatment and Education Fund: Legislative Report Fiscal Year 1997-1998. 54
Substance Abuse in Arizona: 1999
Table 4-2
PROBATIONERS Services Probation Departments May Provide to Probationers
Counseling Educational Group therapy Individual counseling Family preservation model College courses Drug education English as a Second Language General Education Diploma programs Learn Labs Includes monitoring of seriously mentally ill offenders in Pima County IPS/Electronic monitoring in Pima and Santa Cruz Counties Anger management Community placement Crisis intervention Domestic violence prevention services Employability skills curriculum Job placement (Department of Economic Security) Job search Job training Life skills to teach household budgets and parenting programs Mental health services Motivation Non-violence education Residential placement Womens' shelters After care (not available in Graham County) Cognitive intervention program Custodial treatment Day treatment Detoxification Halfway house (not available in Graham County) Intensive outpatient Lapse/relapse Long-term inpatient Outpatient services PHF: Psychiatric Health Facility/Behavioral Therapy Recovery Residential treatment Sex offender treatment SOS: Secular Organizations for Sobriety in Pima County Treatment for seriously mentally ill offenders in Pima County Various substance abuse treatment programs Vocational rehabilitation Twelve-step programs
Monitoring Social Services
Treatment
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Table 4-2 (continued)
Other
Aggravated DUI caseloads Assessments Bus passes (not available in Graham County) Case reviews Changing Lives through Literature program with judge CPP: Community Punishment Program Day reporting Diversion program (not available in Graham County) Drug court DTEF House arrest MADD Phoenix Suns Night Hoops for Maricopa County males aged 18-25 who have completed a life skills class Salvation Army Shock incarceration Spanish speaking probation officers Teen challenge Work furlough Victory outreach
Differences in Programs Between Counties
There are major differences in the types of programs available to probationers and may vary from county to county. There are differences in rural and metropolitan programs. For example, in some rural counties, drug treatment can involve the use of a twelvestep program including cognitive therapy in a group setting. However, twelve-step programs are not used in Maricopa County due to the spiritual nature of the material discussed in these programs 17. The same holds true for the teen challenge program: while some judges strongly support the program, other counties do not widely participate in it because it is spiritual in approach. (However, the Drug Treatment Education Fund coordinator at the Arizona Administrative Office of the Courts has noted that the use of different strategies is an important factor in the success of drug treatment.) Some counties choose to use group counseling rather than individual counseling because they believe that probationers get more out of the group dynamics. Also, there are differences among services due to quality of the services the probation department can afford to provide. For example, alternatives to residential treatment are often used because of the cost of the program; however, these programs often lack the aftercare that more expensive programs offer. All probation officers interviewed agreed on the value of a "wrap around" strategy that integrates the counselor, case manager and probationer working together as a team to achieve the probationer's goals.
17
According to the pamphlet, "This is A.A....an introduction to the AA recovery program", the Alcoholics Anonymous program notes the reliance of its members on a greater power, although they do not refer to any one religion in particular. 56
Substance Abuse in Arizona: 1999
Barriers to Services
Unfortunately, probation offices in rural counties throughout Arizona have a hard time providing services to their clients. One problem is the location of services relative to the probationer. It is common for rural counties to have an inadequate number of providers. The situation becomes even more difficult when the provider and the probationer do not live in the same town. Additionally, many probationers do not have the means of transportation to get to appointments. To solve this problem, many probation departments offer bus passes to their clients, but not all counties are able to provide this service. Similarly, probation officers in rural counties usually have a more difficult time in contacting their clients. A probation officer in a rural area with the same caseload as a probation officer in a metropolitan area will have a more difficult time in visiting their clients as often as they would like to because the distance between the probation department and the client is often so great. Often more time is spent getting to the client than being able to interact with them. The Drug Treatment Education Fund Coordinator at the Administrative Office of the Courts thinks more money is needed to support rural areas. Some counties have found ways to reduce this problem by sharing services with neighboring counties. For example, in providing residential treatment, many rural counties send their probationers to Maricopa and/or Pima counties for the services.
Reported Trends in Probationers' Substance Use
The probation officers participating in the group interviews offered the following insight in substance use trends: Most probation officers agreed that two-thirds of Arizona's probation caseloads are drug related. Probation officers from Gila, Maricopa, Pinal and Yuma Counties agreed this figure was higher, with 80 to 85% of all probationers having substance abuse related issues in their jurisdictions. In Pinal County 25% of indictments are for drug offenses, according to officers of the Pinal County probation office. The City of Douglas in Cochise County is arresting a higher number of middle aged males for DUI, according to the probation officer representing Cochise County. In Tucson, one part of town is no longer worse than another part of town in terms of drug abuse according to the two Pima County probation officers interviewed.
Women on Probation
Not all county probation departments are experiencing an increase in the number of women on probation. While Santa Cruz County is experiencing a decreased female probationer count, other counties are dealing with an increase of female probationers. In Graham County, for example, 30% of probationers are white males, 30% are Hispanic males, and 40% are white women.
Substance Abuse in Arizona: 1999
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Characteristics of females on probation in Graham County, according to their probation department representative, indicate that 99% of them are methamphetamine users; they have three or more children; they may revert to alcohol while on probation; 90% smoke cigarettes; they start using drugs at 17 years of age; they have a low self-esteem; they are codependent upon a substance abusing male; they are supported in part by Aid to Families with Dependent Children; they have minimal support systems; they fear being alone; and they are victims of domestic violence.
What's Missing
During the group interviews, the probation officers were asked what tools they thought were needed to help in their efforts to reduce substance abuse in Arizona. This section describes their reported needs. In their meeting, the central counties (Gila, Maricopa, Pima, and Pinal) called for a three pronged approach to the treatment of a probationer. They said the probationer, the probation officer, and the treatment providers need to work together as a team to help the probationer achieve the conditions of their probation. However, the officers reported this is sometimes difficult because some treatment providers will work only on the condition of confidentiality. The central counties also felt it was important to include the families in the treatment of the probationer. While all counties acknowledged that the family component was an important one and that family support programs were needed, much less work is done with the families. This happens because a family member or members cannot be required to attend any counseling or other sessions when the probationer is an adult-- only the adult probationer can be required to participate. Maintaining a fully staffed probation department plays a large role in the success of the probationers needing services. In Maricopa County, the average length of employment at the county adult probation department is eighteen months. Changes in staff, coupled with difficulty in recruitment, decrease the assistance the probationers would be receiving otherwise. Probation officers provide an important element for their clients' motivation, and without this quality the productivity of the probationer decreases. For some probation departments, their main problem isn't necessarily the turnover rate that needs to be examined, but rather the need to give the probation departments or courts more tools to affect change. These include the expanded ability to impose jail time when conditions are not met, incentives to keep probationers off drugs, and other sanctions that serve as a "hammer" for continued abuse/neglect of the conditions of probation. Also, most county probation officers stated they would like more in-house programs that are longer and conducted with smaller groups of probationers (lower staff to probationer ratio). The officers also believed the programs that are in place should include an outcome evaluation.
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Substance Abuse in Arizona: 1999
Finally, probation officers described a lack of services that stems from one or both of the following: (1) lack of funds or (2) grants that are too legislatively controlled. An example of a lack of funds is that placing one probationer in residential treatment can deplete funds, leaving other probationers without the funds for appropriate services. Some materials are not within the allowed budget. In another example, psychiatric services and medications are not used because the funds allocated by counties are insufficient for the provider. Funds are always limited, but there are instances when funds are set aside for a specific purpose, and cannot be used even though expenditures may conform with the mission of the fund. For example, substance users who committed an act of domestic violence or other violent crime are not eligible for substance abuse treatment for limited jurisdiction cases, but some Superior courts believe these probationers should be eligible for services under the grant. In another example, a person on probation for selling drugs is not eligible for substance abuse treatment, but a person on probation for burglary is.
Conclusions
From the group interviews of the probation officers (DTEF coordinators), the following insight was gained: A description of the average probationer was sketched, including family history and criminal justice involvement. Marijuana, alcohol, cocaine and methamphetamine are the drugs of choice of probationers. However, this list is not in order: marijuana use may be higher in one area while alcohol is higher in another area. Services available to the probationer were described along with barriers to implementation. Needs of the probation departments to affect change were explored.
Substance Abuse in Arizona: 1999
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Substance Abuse in Arizona: 1999
CONCLUSIONS
The substance abuse data presented in this report has outlined student patterns of substance abuse through the last decade. It has shown that some substances are cyclical in nature by growing and diminishing in popularity as shown in the pattern of lifetime methamphetamine use among high school students. Other drugs have been rising steadily, as shown in the trend of marijuana use among high school students. The probation officers in one of the three group interviews provided remarkable insight into why it is important to look at the substance use patterns of students not currently in the criminal justice system in comparison to adults on probation. When reading through the 1997 version of the Substance Abuse and Public School Students report published by the Arizona Criminal Justice Commission in 1998, several of the probation officers interviewed reported there is a similarity between high school substance use and the substance use among adults in their respective counties. Their observations illustrate an important point: substance use among students should be curtailed as early in life as possible so students will not bri

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ARIZONA CR IMIN AL JUSTICE COMMISSION
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SUBSTANCE ABUSE IN ARIZONA
ARIZONA CRIMINAL JUSTICE COMMISSION
Chairman BARBARA LAWALL Pima County Attorney
Vice Chairman JAN BREWER Maricopa County Board of Supervisors
TERRY L. STEWART, Director Department of Corrections
DENNIS GARRETT, Director Department of Public Safety
KATHRYN D. BROWN, Chairman Board of Executive Clemency
DAVID K. BYERS, Director Administrative Office of the Courts
JANET NAPOLITANO Attorney General
WILLIAM HOLOHAN Chief Justice Retired
RICHARD M. ROMLEY Maricopa County Attorney
WILLIAM ROBINSON, Chief Yuma Police Department
CHARLES HASTINGS Yavapai County Attorney
CLARENCE DUPNIK Pima County Sheriff
TOM SHEAHAN Mohave County Sheriff
JOSEPH ARPAIO Maricopa County Sheriff
Executive Director MICHAEL D. BRANHAM Statistical Analysis Center Director MICHELLE C. WATKINS Research and Statistical Analyst CARIE ANN MCKENNA
ARIZONA CR IMIN AL JUSTICE COMMISSION
1 9 9 9
SUBSTANCE ABUSE IN ARIZONA
THIS PUBLICATION WAS SUPPORTED BY AWARD NO. 99-DB-MU-0004 AWARDED BY THE BUREAU OF JUSTICE ASSISTANCE, OFFICE OF JUSTICE PROGRAMS. THE OPINIONS, FINDINGS,
AND CONCLUSIONS OR R COMMENDATIONS EXPRESSED IN THIS PUBLICATION ARE THOSE OF E THE AUTHOR(S) AND DO NOT NECESSARILY REFLECT THE VIEWS OF THE DEPARTMENT OF
JUSTICE. THIS DOCUMENT IS AVAILABLE IN ALTERNATIVE FORMATS BY CONTACTING THE COMMISSION OFFICE AT (602) 230-0252.
TABLE OF CONTENTS
EXECUTIVE SUMMARY ............................................................................................................ 3 INTRODUCTION ............................................................................................................................. 3 Public School Substance Use Survey...........................Error! Bookmark not defined. Adult Probation Officer Group Interviews ..................... Error! Bookmark not defined. REPORT OVERVIEW..............................................................ERROR! BOOKMARK NOT DEFINED. Elementary School Students .......................................... Error! Bookmark not defined. Junior High/Middle School Students ............................. Error! Bookmark not defined. High School Students ...................................................... Error! Bookmark not defined. Substance Abuse Among Adult Probationers..............Error! Bookmark not defined. CONCLUSION.........................................................................ERROR! BOOKMARK NOT DEFINED. INTRODUCTION .......................................................................................................................... 9 SUBSTANCE USE SURVEY HISTORY ......................................................................................... 10 The Student Surveys...........................................................................................................10 The Student Sample ........................................................................................................... 10 Student Survey Administration Procedure ...................................................................... 11 ADULT PROBATION OFFICER GROUP INTERVIEWS...................................................................11 REPORT OVERVIEW...................................................................................................................12 ELEMENTARY SCHOOL STUDENTS..................................................................................13 INTRODUCTION ........................................................................................................................... 13 PREVALENCE OF SUBSTANCE USE: EVER IN LIFE, IN LAST MONTH AND IN LAST WEEK........13 Comparison to 1997 Elementary School Substance Use Rates ................................. 14 TRENDS AMONG ELEMENTARY SCHOOL STUDENTS IN ARIZONA: 1991 TO 1999...................15 CONCLUSIONS............................................................................................................................17 JUNIOR HIGH/MIDDLE SCHOOL STUDENTS ................................................................... 19 INTRODUCTION ........................................................................................................................... 19 PREVALENCE OF SUBSTANCE USE: EVER IN LIFE, LAST MONTH AND LAST WEEK.................20 Comparison to 1997 Junior High School Substance Use Rates ................................. 20 TRENDS AMONG HIGH SCHOOL STUDENTS IN ARIZONA: 1991 TO 1999................................21 AGE AT FIRST USE: 1999..........................................................................................................24 DEMOGRAPHIC COMPARISONS: STUDENTS WHO HAVE USED A SUBSTANCE AT LEAST ONCE IN THEIR LIVES...........................................................................................................................24 SUBSTANCE USE WHILE ON SCHOOL GROUNDS......................................................................26 Attending School Under the Influence of Alcohol or Drugs .......................................... 26 Student Use of Drugs or Alcohol at School.....................................................................27 ATTITUDES AND PERCEPTIONS CONCERNING SUBSTANCE USE..............................................28 Perceived Effect of Substance Use on Social Life and Attitude Toward School.......28 Attitudes Concerning Peer Substance Use and Related Behaviors ........................... 28 Driving Under the Influence of Alcohol or Drugs ............................................................ 29 Differences in Attitudes between Students That Do/Do Not Use Substances .......... 30 RELATIONSHIP BETWEEN SUBSTANCE USE AND SELECTED FACTORS ................................... 30 School Achievement ........................................................................................................... 30
Substance Abuse in Arizona: 1999 1
Participation in Extracurricular Activities..........................................................................32 CONCLUSIONS............................................................................................................................33 HIGH SCHOOL STUDENTS....................................................................................................35 INTRODUCTION ........................................................................................................................... 35 PREVALENCE OF SUBSTANCE USE: EVER IN LIFE, LAST MONTH AND LAST WEEK.................35 Comparison to 1997 High School Substance Use Rates ............................................. 36 Comparison to 1998 National Data of High School Seniors.........................................36 TRENDS AMONG HIGH SCHOOL STUDENTS IN ARIZONA: 1991 TO 1999................................37 AGE AT FIRST USE: 1999..........................................................................................................40 DEMOGRAPHIC COMPARISONS: STUDENTS WHO HAVE USED A SUBSTANCE AT LEAST ONCE IN THEIR LIVES...........................................................................................................................40 SUBSTANCE USE WHILE ON SCHOOL GROUNDS......................................................................42 Attending School Under the Influence of Alcohol or Drugs .......................................... 42 Student Use of Drugs or Alcohol at School.....................................................................43 ATTITUDES AND PERCEPTIONS CONCERNING SUBSTANCE USE..............................................44 Perceived Effect of Substance Use on Social Life and Attitude Toward School.......44 Attitudes Concerning Peer Substance Use and Related Behaviors ........................... 44 Driving Under the Influence of Alcohol or Drugs ............................................................ 45 Differences in Attitudes Between Students That Do/Do Not Use Substances .......... 46 RELATIONSHIP BETWEEN SUBSTANCE USE AND SELECTED FACTORS ................................... 46 School Achievement ........................................................................................................... 46 Participation in Extracurricular Activities..........................................................................48 CONCLUSIONS............................................................................................................................49 ADULT PROBATIONER SUBSTANCE USE ....................................................................... 51 INTRODUCTION ........................................................................................................................... 51 PROBATIONER DRUGS OF CHOICE............................................................................................52 ASSESSMENT OF PROBATIONERS ............................................................................................. 54 SERVICES AVAILABLE TO PROBATIONERS ................................................................................ 54 Differences in Programs Between Counties ................................................................... 56 Barriers to Services ............................................................................................................. 57 REPORTED TRENDS IN PROBATIONERS' SUBSTANCE USE ...................................................... 57 Women on Probation .......................................................................................................... 57 WHAT'S MISSING ....................................................................................................................... 58 CONCLUSIONS............................................................................................................................59 CONCLUSIONS.........................................................................................................................61 ACKNOWLEDGEMENTS ........................................................................................................ 63 APPENDIX A .............................................................................................................................. 65 ELEMENTARY SUBSTANCE ABUSE SURVEY..............................................................................65 APPENDIX B .............................................................................................................................. 75 SECONDARY SUBSTANCE ABUSE SURVEY ............................................................................... 75
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Substance Abuse in Arizona: 1999
EXECUTIVE SUMMARY
Introduction
Arizona Revised Statute 41-2416 requires that the Arizona Criminal Justice Commission conduct a statewide survey to "measure both the attitudes and the actual prevalence and frequency of substance abuse by children and adults." In accordance with ARS 41-2416, the ACJC Statistical Analysis Center conducted two separate drug use evaluations of: 1) statewide public school students in grades three through twelve; and 2) probation officers across the state about adult probationer drug use. The results of these surveys have been compared to previous data and are detailed in this executive summary. Arizona is unique to the rest of the nation in that our drug use patterns differ from those shown on a national level. Prior to creating policy or evaluating the effects of state programs, it is important to look at data specific to the state of Arizona rather than national data alone. This report evaluated Arizona student's usage frequency of tobacco, smokeless tobacco, alcohol, marijuana, cocaine, meth/amphetamines, depressants, inhalants, hallucinogens, narcotics and steroids. Public School Substance Use Survey In 1988, the Arizona Criminal Justice Commission conducted its first substance use survey among high school students, college students and adults. Elementary and junior high/middle school participation began in 1990. Because of considerable legislative and public interest, the Substance Use Survey Program will continue to include a biennial assessment of elementary, junior high/middle and high schools. State public schools were randomly selected for participation in this survey. However, the sample was structured so that as many counties as possible would be proportionally represented. If a school declined participation, another was randomly selected from the same county. A total of 29 schools and 9,093 students participated in the 1999 survey. Of those, 968 are elementary students, 3,537 are junior high students and 4,588 are high school students. Participating schools administered the survey to all students in attendance in grades three through twelve. Two versions of the survey were administered: one for students in grades three through six and another for those in seventh through twelfth grades. While these two versions are very comparable, the secondary survey contains additional, and more in-depth, questions. The 1999 Substance Use Survey was administered in the fall of 1999. School principals and teachers were provided detailed instructions for administering the survey. Students' anonymity was emphasized and facilitated through the provision of blank
Substance Abuse in Arizona: 1999
3
cover sheets to conceal answers while completing the survey. Upon completion, all surveys were returned to the Commission, whereupon the data was electronically scanned onto disk and results were analyzed. Individual schools' data were aggregated for this report to maintain confidentiality. Adult Probation Officer Group Interviews To gather information regarding adult substance use, all county adult probation officers involved in the Drug Treatment and Education Fund (DTEF) administered by the Arizona Administrative Office of the Courts were asked to participate in one of three regional group interviews with Commission staff. The purpose of the interviews was to generally discuss probationer attitudes and behaviors about substance use in order to gauge adult use among the general adult population. These probation officers (called the DTEF Coordinators) were selected as an interview group because of their work with adult offenders.
Report Overview
This report presents the findings of the 1999 public school student survey and the DTEF Coordinator group interviews. The 1999 student survey results were also compared to previous years, with elementary, junior high/middle and high school findings presented in separate sections. A general discussion of all results, alo ng with their generalizations and limitations, are presented thereafter. Elementary School Students The 1999 substance use survey shows that in comparison to earlier administrations of the survey almost all substance use among elementary school students is remaining constant. In terms of lifetime, monthly, and weekly use, elementary school students have generally maintained their levels of use since early administrations of the survey, even though a limited number of schools participated. Junior High/Middle School Students In 1999, almost all substance use among junior high school students remained consistent with what was reported in 1997. In terms of lifetime, monthly, and weekly use, junior high school students have generally either decreased or maintained their levels of use. With two exceptions, female junior high school students are using substances at similar rates to male students. Of those surveyed, females tend to use inhalants at a rate 24 percent higher than that of males in the same grade. The largest difference between male and female use occurs in smokeless tobacco use, which is used twice as often among male students.
4
Substance Abuse in Arizona: 1999
The majority of junior high school students reported they disapproved of smoking in 1999. Of the students who reported approval of smoking, more approved of smoking in 1999 than was reported in 1997. The approval rate was higher among students who currently smoke than those that do not smoke. Among students who have used alcohol, attitudes toward alcohol use have not significantly changed since 1997: slightly more students who have never used alcohol approve of its use by their peers. Junior high school students who make better grades tend to use substances less frequently than those students who make lower grades, and students who participate in extracurricular activities tend to use substances less frequently than students who do not participate. Employed students report higher usage rates for all evaluated substance categories than those students who are not employed. Of the 19.1 % employed junior high school students, 73.8% reported using substances at least once in their lifetime. High School Students According to the 1999 survey results, alcohol and cigarettes are the most frequently used substances among high school students. Marijuana is the third most commonly used substance across all three temporal measures. Over three quarters of surveyed high school students reported trying alcohol, 62.6 percent reported trying cigarettes, and 49.5 percent reported trying marijuana. A comparison between Arizona high school seniors in 1999 and national high school seniors in 1998 shows that the proportions of Arizona seniors who have smoked cigarettes or had alcohol are comparable to other seniors across the nation. However, fewer Arizona seniors are smoking on a monthly basis in comparison to national figures. (This could be due to the strong presence of anti-smoking campaigns such as the Tobacco Education Prevention Program (TEPP), which is a branch of the Arizona Department of Health Services.) Overall, when comparing substance use among high school seniors with previously collected data, cigarette, smokeless tobacco and methamphetamine use have all decreased. Students tend to disapprove of substance use more often than they approve of it. Cigarette use, which is one of the more common substances used among the high school population, is the substance that most students believe it is the user's choice to smoke; however, only 4.2 percent of students approve of smoking. Alcohol, another popular substance, produces much the same attitudes as cigarette use, but more students (11.1 percent) approve of its use. In general, a higher percentage of students reported an attitude of disapproval for all substances in 1999 than was reported by students in 1997. Comparing the substance use rates between males and females shows that females are now using substances at similar rates to males.
Substance Abuse in Arizona: 1999
5
As was seen among junior high students, high school students who participate in extracurricular activities tend to use substances less frequently than students who do not participate. Employed students report higher usage rates for all evaluated substance categories than those students who are not employed. Of the 42.5 % employed high school students, 87.6 % reported using substances at least once in their lifetime. Substance Abuse Among Adult Probationers In the spring of 2000, staff from the Arizona Criminal Justice Commission met in a group interview format with probation officers from across the state to discuss drug use among adult probationers. The purpose of these interviews was to learn more about adult substance use. The highlights from those interviews are described in this section. The probation officers almost unanimously agreed that alcohol, marijuana, methamphetamine and cocaine were the most abused drugs among adult probationers in their respective counties. While this is generally true across Arizona, these four drugs are in no particular order; methamphetamine may be the drug of choice in one area while cocaine is the drug of choice in another area. Providing drug treatment to the probationers using these substances creates challenges for the probation departments. While there are no formal research-based strategies for dealing with substance abusing offenders, all are assessed at intake to determine drug treatment needs. Many probation departments have too few providers able to handle the necessary services needed by probationers. Some counties have partially solved this problem by sharing services with neighboring counties. For example, in providing residential treatment, many rural counties send their probationers to Maricopa and/or Pima counties because they are more equipped to provide these services. The probation officers participating in the group interviews provided great insight related to substance abuse trends among adult probationers. Some of the trends and facts they reported were: Marijuana, alcohol, cocaine and methamphetamine are the drugs of choice of probationers. While it is not widespread, the probation officers reported they were witnessing more adults and juveniles becoming involved in the transportation/distribution of drugs. The probation officers reported that most probationers have a moderate to severe substance problem, and of these offenders, most were under the influence of drugs at the time of the offense. In their meeting, the central counties (Gila, Maricopa, Pima, and Pinal) called for a three pronged approach to the treatment of probationers. They said the probationer, the probation officer and the treatment providers need to work together as a team to help the probationer achieve the conditions of their probation. However, the officers reported this is sometimes difficult because some treatment providers will work only on the condition of confidentiality. While all counties acknowledged that the family component was an important one and that family support programs were needed, much less work is
6
Substance Abuse in Arizona: 1999
done with the families. The main reason given for not working more closely with the families is that a family member or members cannot be required to attend any counseling or other sessions when the probationer is an adult--only the adult probationer can be required to participate. For some probation departments, giving the probation department or court more tools to affect change should be examined. These include the ability to impose jail time when conditions are not met, incentives to keep the probationers off drugs and other sanctions in general that could serve as a "hammer" for continued abuse/neglect of the conditions of probation. Also, almost all counties stated they would like more in-house programs that are longer and are conducted with smaller groups of probationers (lower staff to probationer ratio). Those programs that are in place should include an outcome evaluation. Finally, the probation officers described a lack of services that stems from one or both of the following: (1) lack of funds; or (2) grants that are too tightly controlled. An example of a lack of funds is that placing one probationer in residential treatment can deplete funds, leaving other probationers without the funds for appropriate services. Some materials are simply too expensive given the allowed budget. While there has always be an argument that money is too tight, there are instances when funds set aside for a specific purpose are so stringent that the funds aren't able to be spent even though it conforms with the mission of the fund. For example, substance abusers that committed an act of domestic violence or other violent crime are not eligible for substance abuse treatment for limited jurisdiction cases, but some Superior Courts believe these probationers should be eligible for services under the grant. The Arizona Criminal Justice Commission's public school substance use survey and group interviews with probation officers yield very important and useful data. The substance use survey provides an estimate of the number of our youth using both legal and illicit substances and the frequency at which they are used. The adult probation officer group interviews shed some light on adult substance patterns that are closely related to the use experienced by the adult population. The full report provides a more comprehensive discussion of the results of both these projects.
Conclusion
The connection between public school student substance abuse and the substance patterns of probationers is apparent. This report shows that methamphetamine, marijuana, alcohol and cocaine are the most heavily u ed illicit substances in society s today, both among high school students and among adult probationers. The criminal justice community is well aware and has documented the relationship between drug use and criminal activity, and until we can reduce the prevalence of drug use we are likely to see continued illegal behaviors. For these reasons, the criminal justice community is in support of drug prevention education as a method of preventing criminal drug-related activity in the future.
Substance Abuse in Arizona: 1999
7
A focus on drug prevention programs that have proven effective in the classroom, coupled with a focus on the current needs of the criminal justice system to provide quality drug treatment in all areas of the state are critical to increasing the effectiveness of the criminal justice system. In addition, it is suggested the drug treatment needs of citizens outside of the criminal justice system be assessed in an effort to keep them from ever entering the criminal justice system. These priorities will advance the criminal justice system in its overall mission to reduce crime and increase safety in all Arizona communities.
8
Substance Abuse in Arizona: 1999
INTRODUCTION
Arizona Revised Statute 41-2416 requires that the Arizona Criminal Justice Commission conduct a statewide survey to "measure both the attitudes and the actual prevalence and frequency of substance abuse by children and adults." This report has been created to fulfill this requirement. The following sections of this report will further describe the public school student substance use survey and adult probation officer group interviews. When looking at substance use throughout Arizona, it is important to look at data specific to the state of Arizona rather than national data. Arizona has unique circumstances that create drug use patterns different than those shown on a national level. For example, a national study by the Partnership for a Drug -Free America shows that marijuana use has stabilized and that other illicit drug use has declined; however, this is not necessarily the case in Arizona 1. Of special interest is the information in the student substance abuse survey results regarding attitudes toward drug use. According to the University of Michigan's Monitoring the Future study, the "perception of risk (how risky consumers view a particular drug) and perception of social disapproval (consumer appeal and acceptance of a particular drug)" have helped to guide substance consumption patterns (Partnership for a Drug-Free America, 5). 2 For this reason, the lack of social disapproval among students about student use, such as the common attitudes reported here that student use of drugs is the decision of the user, is an important predictor of future increases in drug use. To collect substance use information throughout Arizona, the Arizona Criminal Justice Commission's Statistical Analysis Center conducted two separate evaluations. First, a survey was administered in a statewide sample of public schools. Teachers working in the selected schools administered the survey to students in grades three through twelve. The Commission has been conducting this survey for twelve years on a biennial basis, and the results of this survey along with those of prior years will be compared. Secondly, Commission staff talked with adult probation officers about adult probationer use by conducting three group interviews across the state. This is the first time in over a decade that the Commission was able to successfully report on adult prevalence. Future plans include further exploration of this area.
1
Partnership for a Drug-Free America (2000). More Parents Talking with Kids About Drugs More Often, And Appear to Be Having An Impact. April 11, 2000 Press Release. 2 Partnership for a Drug-Free America (2000). Partnership Attitudes Tracking Study: Spring 1999 Parents. 9
Substance Abuse in Arizona: 1999
Substance Use Survey History
In 1988, the Arizona Criminal Justice Commission conducted its first substance use survey among high school students, college students and adults. This groundbreaking survey allowed for the development of baseline information on substance use levels in the state. Elementary and junior high/middle school participation began in 1990. University and community college surveys were performed in 1988, 1990, and 1991, and general public substance use surveys were conducted in 1988 and 1990. Because of considerable legislative and public interest, the Substance Use Survey Program will continue to include a biennial assessment of elementary, junior high/middle and high schools. The college and general public surveys will be conducted whenever feasible given a vailable resources. The Student Surveys The Arizona Public School Substance Use Survey was revised in 1997 prior to administration to improve its organization, comprehensiveness, and comprehension. It measures the prevalence, frequency, and effects of, as well as attitudes toward, substance use of youth enrolled in Arizona primary and secondary public schools. The survey also contains questions about gangs, such as personal involvement, the perceived presence of gang members in one's family, school, and neighborhood, and illegal gang activities. In 1997, questions were added regarding weapons and perceived safety while at school. Finally, demographic variables, school attitude and achievement, and extracurricular activity involvement are measured. Althoug h the 1997 survey was designed to allow for comparison with previous years' data, it is possible that changes to the survey (e.g., content, format, order of the questions, etc.) affect its comparability. For example, short descriptions of each substance we re added, including common "street names," to improve the survey's comprehension. While this may not initially appear problematic, students may report higher or lower levels of use simply because they better understand the meaning of the surveyed substances.
The Student Sample
State public schools were randomly selected for participation in this survey. However, the sample was structured so that as many counties as possible would be proportionally represented. (Representation of all counties is not required in the statewide sample as long as an excluded county is represented regionally through an adjoining county's participation.) If a school declined participation, another was randomly selected from the same county to replace it. Several school administrators declined participation in the project, for a variety of reasons, and other schools dropped out of the sample after confirming participation. While a reduced participation rate can affect the survey results and the sample, it is very common and virtually unavoidable in this type of research.
10
Substance Abuse in Arizona: 1999
A total of 29 schools and 9,093 students participated in the 1999 survey. Of those, 968 were elementary students, 3,537 were junior high students, and 4,588 were high school students. Because a limited number of elementary schools participated in the survey, the elementary school results cannot be considered representative of the entire state and are therefore best interpreted with caution. Participating schools administered the survey to all students in attendance in grades three through twelve. Two versions of the survey were administered: one for students in grades three through six and another for those in seventh through twelfth grades. While the two versions are very comparable, the secondary survey contains additional, and more in depth, questions. Student Survey Administration Procedure The 1999 Substance Use Survey was administered in the fall of 1999. School principals and teachers were provided detailed instructions to use when administering the survey. Surveys were to be administered to students within each school without prior notice, at the same time, and in students' regular classroom setting, whenever possible. Students' anonymity was emphasized and facilitated through the provision of blank cover sheets to conceal answers while completing the survey. Elementary teachers (grades three through six) were instructed to read the survey aloud as students completed it to aid comprehension of the questions. Once administration was completed, teachers were instructed to immediately seal their class' surveys in a provided envelope. Upon completion, all surveys were returned to the Commission, electronically scanned onto disk, and analyzed. Individual schools' data were aggregated for this report to maintain confidentiality.
Adult Probation Officer Group Interviews
To gather information regarding adult substance use, all county adult probation officers involved in the Drug Treatment and Education Fund (DTEF) administered by the Arizona Administrative Office of the Courts were asked to participate in one of three regional group interviews with Commission staff. Representatives from all but two counties (Greenlee and La Paz) participated in the interviews. The purpose of the interviews was to generally discuss probationers' attitudes and behaviors about substance use in order to gauge adult use among the general adult population. These probation officers (called the DTEF Coordinators) were selected as an interview group because of their work with adult probationers. The substance use patterns of adult probationers was explored because their substance use patterns are more widely known than the general population. Because it is expensive to reach the general adult population by telephone interviews or written questionnaires, adult probationers were chosen for study because they are a more accessible group of adults to study than the general population.
Substance Abuse in Arizona: 1999
11
Report Overview
The remainder of this report presents the findings of the 1999 public school student survey and the DTEF Coordinator group interviews. The 1999 student survey results are also compared to previous years, with elementary, junior high/middle, and high school findings presented in separate sections. A discussion of adult probationer substance abuse is presented thereafter. The Appendix at the end of the report contains copies of the elementary and secondary student survey instruments used in 1999. Care must be taken not to draw cause and effect conclusions from the data contained in the public school student survey portions of this report. If one group of students yields higher levels of use than another group (e.g., females compared to males), it cannot be concluded that group membership alone (e.g., sex) causes the resulting levels of use. While different groups may yield different levels of substance use, it can only be concluded that there may be some type of relationship between that variable (e.g., sex) and substance use, not that the variable causes certain levels of substance use. Factors other than group membership that was not measured by the survey may be contributing to the observed relationships between variables. Such possibilities can be explored through more detailed research projects.
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Substance Abuse in Arizona: 1999
ELEMENTARY SCHOOL STUDENTS
Introduction
In recent years, drug prevention efforts have been targeted at students in lower grades in response to increasing use among elementary school students. This chapter will discuss the frequency of substance use among elementary school students and how this use has changed in the last decade. A total of 971 elementary public school students across the state participated in the 1999 Substance Use Survey. More rural schools participated than urban schools, which is of some concern because about 60% of Arizona's population reside in metropolitan areas. The sample contains 49.0% females and 51.0% males, and is thus representative of the state's population of elementary public school students. The race composition of the elementary sample is the following: 30.2% White (not Hispanic), 54.9% Hispanic, 4.3% American Indian, 3.1% Black (not Hispanic), and 7.5% Other (including Asian). Although White students are somewhat under represented and Hispanic students are somewhat over represented, the figures compare well to the state population of public school students in grades three through six. The grade distribution of the sample is relatively even: 26.3% of the students surveyed are in the third grade, 29.1% are in fourth grade, 24.5% are in fifth grade, and 20.1% are in the sixth grade. These figures compare well to the state's population of elementary students. The smaller proportion of sixth graders is partially accounted for by the fact that some school districts enroll their sixth graders in junior high rather than elementary school. This group of students will be represented in the junior high/middle school section of the report. These data were not analyzed with the elementary sample due to the fact that simply attending a middle school may affect reported behaviors and experiences.
Prevalence of Substance Use: Ever in Life, In Last Month and In Last Week
The 1999 survey of elementary school students shows that alcohol and cigarettes are the substances most commonly used among third through sixth graders (see Table 11). Overall, about one in every four elementary students has used alcohol before, and 16.8% of all elementary students have used cigarettes. Inhalant use among respondents is also common: it has been used by 8.9% of elementary school students. Smokeless tobacco and marijuana have been used by the same proportion of elementary school students with about 6% of students trying each drug. Each of the remaining six substances have been tried by 3.5% or fewer students. Use of all substances declines considerably as the frequency of use increases. Among elementary school students, this is especially apparent for cigarettes, alcohol, and smokeless tobacco, where use in the last month is approximately one fourth the proportion of students who have ever tried the substance in their life. Overall, it appears
Substance Abuse in Arizona: 1999
13
that approximately half of elementary school students who have tried the surveyed substances may have done so in an experimental manner and/or have not recently used. The differences between the proportion of elementary students reporting use in the last month and in the last week are considerably smaller. For many of the substances, there is no difference between the proportion of students reporting last month and last week use. This may indicate that those elementary students who have used in the last month are also regular, weekly users.
Table 1-1
ELEMENTARY SCHOOL STUDENTS 1999 Substance Use: Ever in Life, In Last Month and In Last Week
Substance Cigarettes Smokeless Tobacco Alcohol Marijuana Cocaine Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids Ever in Life 16.8% 6.2% 24.4% 6.3% 3.5% 3.0% 2.3% 8.9% 2.2% 3.1% 2.7% In Last Month 4.6% 1.8% 6.6% 3.2% 1.5% 1.2% <1% 4.3% 1.5% 1.7% 1.7% In Last Week 4.4% 2.4% 4.7% 3.0% 1.4% 1.3% 1.2% 3.3% 1.9% 1.2% 1.4%
Comparison to 1997 Elementary School Substance Use Rates While the rates just presented provide a snapshot of substance use, actual increase or decreases become clear when the rates are compared to the rates reported in 1997. In making this comparison, we can see that among all students who have used (in their lifetime, in the last month, and/or in the last week): Cigarette, marijuana, and inhalant use is lower than was reported in 1997; Alcohol use has increased by 23% in comparison to 1997; and All other drugs have not changed in terms of rate of use between 1997 and 1999.
14
Substance Abuse in Arizona: 1999
Table 1-2
ELEMENTARY SCHOOL STUDENTS Substance Use Ever in Life: 1991-1999 Comparison
Substance Cigarettes Smokeless Tobacco Alcohol Marijuana Cocaine Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids 1991 17.2% 5.8% 39.0% 1.7% 0.7% 1.0% N/A 5.9% 1.2% N/A N/A 1993 18.4% 9.8% 30.5% 3.1% 1.4% 1.3% N/A 7.3% 1.6% N/A N/A 1995 16.6% 5.3% 29.2% 5.6% 2.0% 2.1% N/A 6.8% 1.4% N/A N/A 1997 18.3% 6.0% 19.9% 8.2% 3.5% 2.8% 2.3% 10.4% 2.6% 2.2% 2.2% 1999 16.8% 6.2% 24.4% 6.3% 3.5% 3.0% 2.3% 8.9% 2.2% 3.1% 2.7%
Note: This information is not available for depressants, narcotics, or steroids prior to 1997.
Trends Among Elementary School Students in Arizona: 1991 to 1999
A comparison of public elementary school students' use from 1991 to 1999 reveals that use levels for most substances (for which data are available) have changed little over time. Tables 1-2, 1-3, and 1-4 show this is consistent for all three temporal measures of use: ever in life, in the last month, and in the last week. However, an increase in the percent of students who have ever tried a drug does indicate use in the last month or the last week is rising as well. Overall, when looking at the trends of use for each substance the data show: Cigarette use has not changed substantially in terms of lifetime, monthly, or weekly use. Smokeless tobacco use among students who have ever tried the drug rose significantly in 1993, but has been constant ever since. For monthly and weekly use, there have been minimal changes in use. Alcohol lifetime use has increased since 1997, but is still lower than 1991-1995 rates, and monthly use is lower than 1993 and 1995 rates. Weekly use has not changed since 1997, but is slightly lower than the 1995 rate. Monthly, weekly, and lifetime marijuana use has not changed significantly. Cocaine use has not drastically changed in any of the three areas. No large changes in methamphetamine, depressant, hallucinogen, narcotic, or steroid use appears to have occurred over time. Inhalant use in lifetime decreased slightly since 1997. No substantial changes have occurred in monthly and weekly use.
Substance Abuse in Arizona: 1999
15
Table 1-3
ELEMENTARY SCHOOL STUDENTS Substance Use In the Last Month: 1991-1999 Comparison
Substance Cigarettes Smokeless Tobacco Alcohol Marijuana Cocaine Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids 1991 N/A N/A 3.5% 0.3% 0.2% 0.1% N/A 0.9% 0.3% N/A N/A 1993 N/A N/A 10.4% 1.8% 0.4% 0.8% N/A 3.3% 0.9% N/A N/A 1995 N/A N/A 10.6% 3.2% 1.6% 1.6% N/A 3.4% 1.0% N/A N/A 1997 5.7% 2.6% 6.0% 4.0% 1.9% 1.4% 1.3% 4.9% 1.5% 1.0% 1.2% 1999 4.6% 1.8% 6.6% 3.2% 1.5% 1.2% <1% 4.3% 1.5% 1.7% 1.7%
Note: This information is not available for cigarettes, smokeless tobacco, depressants, narcotics, or steroids prior to 1997.
Table 1-4
ELEMENTARY SCHOOL STUDENTS Substance Use In the Last Week: 1993 - 1999 Comparison
Substance Cigarettes Smokeless Tobacco Alcohol Marijuana Cocaine Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids 1993 N/A N/A 5.5% 0.8% 0.3% 0.6% N/A 1.9% 0.6% N/A N/A 1995 N/A N/A 6.8% 2.3% 1.0% 1.3% N/A 2.6% 1.0% N/A N/A 1997 4.5% 2.2% 4.2% 3.2% 1.6% 1.4% 1.2% 4.1% 1.2% 1.1% 1.1% 1999 4.4% 2.4% 4.7% 3.0% 1.4% 1.3% 1.2% 3.3% 1.9% 1.2% 1.4%
Note: Use in the last week was not measured prior to 1993. Also, this information is not available for cigarettes, smokeless tobacco, depressants, narcotics, or steroids prior to 1997.
16
Substance Abuse in Arizona: 1999
Conclusions
A review of substance use among elementary school students at the present time and from previous years indicates that: Most substance use among elementary school students is remaining constant. In terms of lifetime, monthly and weekly use, elementary school students have generally maintained their levels of use.
Substance Abuse in Arizona: 1999
17
18
Substance Abuse in Arizona: 1999
JUNIOR HIGH/MIDDLE SCHOOL STUDENTS
Introduction
Junior high/middle school years are the "experimental" years for substance use. The results of the Criminal Justice Commission's survey of high school students indicates that among students who have ever tried substances in their lives, smokeless tobacco, cocaine, methamphetamine, depressant, hallucinogen, narcotic and steroids were most commonly tried between the ages of 14 and 16. Cigarette, marijuana and inhalant use begins most commonly between the ages of 11 and 133. Exploratory substance usage patterns of junior high school students are different from substance use by high school students, and at different rates. Through monitoring junior high school students' substance use patterns during this experimentation period, their future drug use can be forecasted more clearly. The substance use behaviors of junior high/middle school students are the focus of this chapter. When conducting surveys across the state using a sample of students rather than the entire student population, efforts were made to ensure that the sample of students was representative of the entire student population. In 1999, a total of 3,537 public high school students across the state participated in the substance use survey. The sex, race and grade distributions presented here represent the sample surveyed. The sex breakdown of the 1999 junior high school sample is as follows: 49.5% females and 50.5% males. These figures correlate with the state's population of junior high school students. Therefore, it can be assumed that any differences in the results on the basis of sex will not be due to the sample. The racial make-up of the junior high school sample was also similar to the racial breakdown of Arizona junior high school students. The racial breakdown is as follows: 35.9% White (not Hispanic), 35.6% Hispanic, 12.1% American Indian, 4.1% Black (not Hispanic), and 12.3% Other (including Asian) 4. It is assumed that any differences in the results on the basis of race are not due to the sample construction. The grade ranges represented in the sample contain similar proportions of seventh and eighth grade students (37.9% and 43.9% respectively). The junior high/middle school sample also contains a small proportion of sixth graders (11.5%) and some ninth graders (5.9%) because some school districts enroll their sixth and/or ninth graders in junior high rather than in elementary or high schools.
3
More information regarding substance use among high school students will be reported in the following chapter. 4 Asian and Other race categories were combined and will be reported as such. This was done because the sample of Asian students was relatively small and the initial results of Asian substance use were inflated. 19
Substance Abuse in Arizona: 1999
Prevalence of Substance Use: Ever in Life, Last Month and Last Week
According to the 1999 survey results, alcohol, cigarettes and marijuana are the most frequently used substances among junior high school students (see Table 2-1). Alcohol and cigarettes are the most frequently used substances, with 50.7% of students reporting they had used alcohol at least once in their lives, and 41.0% of students reporting they had ever used cigarettes. Marijuana is the third most commonly used substance, with almost one in four students reporting they have used it at least one time in their lives. In all, 19.8% of junior high school students reported trying inhalants. Each of the remaining illicit substances have been used by less than eight percent of junior high school students. Overall, the percentages of junior high school students who have used substances in the last month are approximately one half of the lifetime use numbers. This would indicate that large proportions of the state's junior high/middle school students who have tried the surveyed substances are not regular and/or current users. For most substances, use in the last week does not show as considerable a drop from last month use figures. However, alcohol use in the last week drops about 35% from use in the last month. Alcohol is the most widely tried substance, and numbers show that about one quarter of students who have tried alcohol have actually used it in the last week, and may well be frequent users.
Table 2-1
JUNIOR HIGH/MIDDLE SCHOOL STUDENTS 1999 Substance Use: Ever in Life, In Last Month, and In Last Week
Substance Cigarettes Smokeless Tobacco Alcohol Marijuana Cocaine Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids Ever in Life 41.0% 10.6% 50.7% 24.1% 7.1% 7.0% 6.9% 19.8% 7.6% 6.9% 6.4% In Last Month 13.0% 4.0% 21.3% 13.1% 4.1% 4.1% 4.2% 8.6% 4.5% 4.3% 4.3% In Last Week 10.1% 3.9% 13.8% 9.7% 3.6% 3.8% 3.7% 6.4% 3.5% 3.8% 4.0%
Comparison to 1997 Junior High School Substance Use Rates
The rates presented above do not indicate whether substance use is increasing or decreasing. However, looking at the rates in comparison to the rates reported in 1997 a better determination of substance use trends among Arizona high school students is obtained. A comparison of the 1999 survey results to the 1997 results, shows that
20 Substance Abuse in Arizona: 1999
among all students who have used (in their lifetime, in the last month and/or in the last week): Cigarette and alcohol use is lower in 1999 than in 1997, Depressant, cocaine, methamphetamine, hallucinogen, narcotic, smokeless tobacco, marijuana and inhalant use has not changed, and Steroid use is higher in 1999 than it was in 1997. A more in-depth discussion of these trends is presented in the next section of this chapter.
Trends Among Junior High School Students in Arizona: 1991 to 1999
A comparison of public junior high school students' use from 1991 to 1999 reveals that use levels for most substances (for which data are available) have fluctuated over this time. Tables 2-2, 2-3, and 2-4 show this is consistent for all three temporal measures of use: ever in life, in the last month and in the last week. However, because substance use may be rising among students who have ever tried a substance in their lives, continued use (such as on a monthly or weekly basis) may not have increased. In some instances, the increased proportion of students trying a substance, but not using it regularly, indicates that students have made a decision not to use the substance after they have tried it.
Table 2-2
JUNIOR HIGH/MIDDLE SCHOOL STUDENTS Substance Use Ever in Life: 1991-1999 Comparison
Substance Cigarettes Smokeless Tobacco Alcohol Marijuana Cocaine Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids 1991 N/A N/A 49.5% 12.3% 3.7% 4.1% 11.0% 14.8% 4.7% 6.1% N/A 1993 N/A N/A 46.1% 19.1% 5.2% 5.7% 11.2% 18.6% 6.4% 6.3% 2.8% 1995 N/A N/A 46.2% 19.1% 6.3% 7.9% 11.0% 17.5% 7.5% 6.0% 3.2% 1997 45.9% 10.9% 54.9% 25.8% 6.1% 5.8% 6.3% 21.1% 6.7% 5.8% 3.6% 1999 41.0% 10.6% 50.7% 24.1% 7.1% 7.0% 6.9% 19.8% 7.6% 6.9% 6.4%
Note: This information is not available for cigarettes or smokeless tobacco prior to 1997.
Substance Abuse in Arizona: 1999
21
Overall, when looking at the trends of use for each substance the data demonstrates that: Cigarette use is slightly lower than the 1997 figure. Monthly use has decreased since its peak i n 1997. Smokeless tobacco use has not changed. Overall alcohol use (in the last week, in the last month and in lifetime) has changed little over time. The proportion of students who have ever used marijuana increased between 1991 and 1997, but has not changed in comparison to 1997 figures. Cocaine use has increased slightly in the three areas: lifetime, monthly and weekly use. Methamphetamine use for all three temporal measures has not changed overall. The percent of students who have tried depressants or used on a monthly or weekly basis has not changed significantly. Inhalant use has not changed in terms of lifetime, monthly or weekly use. Hallucinogen use ever in students' lifetimes has been relatively stable since 1993; monthly use has also remained constant since 1995, and weekly use has changed little. Narcotic use in lifetime, month and last week has remained relatively constant. The percent of students who have used steroids in their lifetime has risen since 1993.
Table 2-3
JUNIOR HIGH/MIDDLE SCHOOL STUDENTS Substance Use In the Last Month: 1991-1999 Comparison
Substance Cigarettes Smokeless Tobacco Alcohol Marijuana Cocaine Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids 1991 18.1% 5.9% 21.4% 5.0% 1.8% 2.3% N/A 7.2% 2.5% N/A N/A 1993 17.3% 7.5% 20.0% 9.4% 2.6% 2.4% N/A 7.3% 3.6% N/A N/A 1995 17.0% 7.1% 20.2% 9.0% 3.0% 3.8% N/A 7.6% 3.8% N/A N/A 1997 18.7% 3.4% 23.7% 13.6% 2.9% 2.6% 3.0% 8.6% 3.0% 2.8% 1.8% 1999 13.0% 4.0% 21.3% 13.1% 4.1% 4.1% 4.2% 8.6% 4.5% 4.3% 4.3%
Note: This information is not available for depressants, narcotics, or steroids prior to 1997.
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Substance Abuse in Arizona: 1999
Table 2-4
JUNIOR HIGH/MIDDLE SCHOOL STUDENTS Substance Use In the Last Week: 1993 - 1999 Comparison
Substance Cigarettes Smokeless Tobacco Alcohol Marijuana Cocaine Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids 1993 N/A N/A 13.1% 8.1% 2.6% 2.5% N/A 5.7% 3.3% N/A N/A 1995 N/A N/A 19.4% 8.5% 3.3% 3.4% N/A 6.1% 3.4% N/A N/A 1997 12.6% 2.4% 12.5% 9.6% 2.1% 1.8% 2.1% 5.8% 1.8% 2.0% 1.6% 1999 10.1% 3.9% 13.8% 9.7% 3.6% 3.8% 3.7% 6.4% 3.5% 3.8% 4.0%
Note: Use in the last week was not measured prior to 1993. Also, this information is not available for cigarettes, smokeless tobacco, depressants, narcotics, or steroids prior to 1997.
Table 2-5
JUNIOR HIGH/MIDDLE SCHOOL STUDENTS 1999 Substance Use: Age at First Use
Substance Cigarettes Smokeless Tobacco Alcohol Marijuana Cocaine Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids 7 or younger 15.0% 17.6% 19.1% 5.1% 10.3% 8.9% 9.9% 8.3% 4.9% 8.5% 12.3% 8-10 40.0% 36.2% 31.2% 28.1% 11.9% 20.1% 19.4% 24.2% 16.7% 22.5% 13.0% 11-13 42.6% 41.5% 46.0% 61.2% 63.8% 60.4% 55.8% 61.9% 62.3% 60.1% 58.3% 14 or older 2.5% 4.7% 3.7% 5.5% 14.0% 10.7% 15.0% 5.7% 16.3% 9.0% 16.4%
Note: This table includes only those students who report ever using each substance.
Substance Abuse in Arizona: 1999
23
Age at First Use: 1999
Table 2-5 represents the age the surveyed substances were first used by junior high school students. Among junior high school students, the most common age of initiation of all substances was between the ages of 11 and 13. Cigarette, smokeless tobacco and alcohol use is frequently started among eight through ten-year olds as well.
Demographic Comparisons: Students Who Have Used a Substance at Least Once in Their Lives
To implement a drug prevention or intervention program, it is important to have detailed information on which students are participating in drug activities so the chances of successfully administering the program will increase. This section describes the prevalence of substance use among those students who have used a substance at least one time in their lives in more detail by breaking this use down by sex, race, and grade. The 1999 survey revealed that substance use, which used to be more prevalent among males than females, is now nearly as common among females as among males. This year's survey clearly reflects the closing of the gender gap in the survey results. Table 2-6 shows that: Females tend to use inhalants more frequently than their male counterparts. The largest difference between male and female use occurs in smokeless tobacco use, which is used more often among males. For all other drugs, female junior high school students use at about the same rate as male students.
Table 2-6
JUNIOR HIGH/MIDDLE SCHOOL STUDENTS 1999 Substance Use Ever in Life: Sex Comparison
Substance Cigarettes Smokeless Tobacco Alcohol Marijuana Cocaine Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids Female 39.7% 6.0% 49.7% 20.4% 5.3% 5.3% 5.4% 19.7% 5.4% 3.7% 3.4% Male 40.0% 11.9% 48.7% 23.4% 4.5% 4.4% 4.5% 15.9% 5.8% 5.5% 4.5%
A review of substance use among different races in Table 2-7 shows that American
24
Substance Abuse in Arizona: 1999
Indian students have the highest cigarette, smokeless tobacco, marijuana, and inhalant use rates. Black students reported the highest use of alcohol. Students self-reported as either an "other" racial identity or as Black have the highest rates of depressant use. The races that use substances most commonly in junior high school, however, are not the most frequent users among high school students. For more information on high school use, please refer to chapter three of this report.
Table 2-7
JUNIOR HIGH/MIDDLE SCHOOL STUDENTS 1999 Substance Use Ever in Life: Race Comparison
Substance Cigarettes Smokeless Tobacco Alcohol Marijuana Cocaine Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids White 37.3% 9.4% 49.5% 19.0% 3.2% 4.0% 5.0% 15.1% 5.1% 4.2% 3.4% Black 44.2% 6.5% 52.2% 27.5% 5.8% 5.8% 8.0% 13.8% 5.8% 5.1% 7.2% Hispanic 37.7% 5.6% 50.6% 19.2% 5.3% 4.9% 4.3% 18.8% 4.7% 4.5% 3.2% American Indian 51.2% 18.7% 42.1% 36.0% 7.9% 4.9% 3.9% 21.4% 7.6% 5.2% 4.2% Asian/ Other 40.2% 10.4% 50.4% 23.2% 6.3% 7.7% 7.5% 19.6% 8.7% 6.1% 7.0%
Almost all rates of substance use among junior high school students increase as they progress from seventh to eighth grade. For example, there is a 103.3% percent change in methamphetamine use between the seventh and eighth grades. Marijua na use is 85.4% higher among eighth graders than among seventh graders. The prevalence of substance use ever in life is presented by grade in Table 2-8.
Substance Abuse in Arizona: 1999
25
Table 2-8
JUNIOR HIGH/MIDDLE SCHOOL STUDENTS 1999 Substance Use Ever in Life: Grade Comparison
Substance Cigarettes Smokeless Tobacco Alcohol Marijuana Cocaine Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids Seventh 32.4% 7.3% 41.1% 15.8% 3.5% 3.0% 3.4% 16.0% 4.1% 3.2% 3.2% Eighth 47.7% 10.9% 59.7% 29.3% 6.0% 6.1% 6.0% 20.8% 7.0% 5.4% 4.4% Percent Increase Between Seventh and Eighth Grades 47.2% 49.3% 45.3% 85.4% 71.4% 103.3% 76.5% 30.0% 70.7% 68.8% 37.5%
Substance Use While on School Grounds
The Substance Use and Public School Students survey asks students not only about their own use patterns, but also about their attitudes toward substance use in general. In this section, the survey results examining substance use and school attendance will be presented.
Attending School Under the Influence of Alcohol or Drugs
In 1999, a smaller proportion of students reported that they had attended school under the influence of drugs than was reported in 1997. In 1999, 12.9% of students reported they had come to school under the influence of alcohol or drugs, which is slightly less than the 15.5% of students who reported the same behavior in 1997. Of the students who have come to school under the influence, most students have engaged in this behavior one or two times. Please see Table 2-9. (Totals may not add up to 100% because not all students surveyed answered the question.)
26
Substance Abuse in Arizona: 1999
Table 2-9
JUNIOR HIGH/MIDDLE SCHOOL STUDENTS 1999 Attending School Under the Influence of Alcohol or Drugs
Use of Alcohol or Drugs Have Never Used Have Used, But Have Never Attended School Under the Influence Have Attended School Under the Influence: - 1 or 2 times - 3 to 5 times - 6 to 9 times - 10 to 19 times - 20 to 39 times - 40 or more times Total Percentage 56.2% 28.1%
5.2% 2.5% 1.8% 1.0% 0.8% 1.6% 12.9%
Student Use of Drugs or Alcohol at School
When comparing the percent of students who attend school under the influence of alcohol or drugs to the percent of students who actually use while on school grounds, it appears that almost as many students use substances while on campus (10.1%). About 5% of surveyed junior high school students report using alcohol or drugs at school one or two times in their lives.
Table 2-10
JUNIOR HIGH/MIDDLE SCHOOL STUDENTS 1999 Use of Alcohol or Drugs at School (Ever in Life)
Use of Alcohol or Drugs Have Never Used Have Used, But Have Never Used at School During Regular School Hours Have Used at School During Regular School Hours: - 1 or 2 times - 3 to 5 times - 6 to 9 times - 10 to 19 times - 20 to 39 times - 40 or more times Total Percentage 57.1% 30.0%
5.1% 1.9% 1.0% 0.9% 0.4% 0.8% 10.1%
Substance Abuse in Arizona: 1999
27
Attitudes and Perceptions Concerning Substance Use
As stated previously, attitudes and perceptions of drug use tend to guide substance consumption patterns. This section examines attitudes about both self-reported and peer substance use and related behaviors. Also included is a comparison of attitudes toward peer behaviors by those students who have participated in the same behaviors.
Perceived Effect of Substance Use on Social Life and Attitude Toward School
The 1999 survey results indicate that approximately two thirds of junior high school students who have used alcohol or drugs believe that their use has not affected their social lives. Almost 70% of those who have used report no effect of their use on their attitude toward school. Of those students who report some type of effect on their social life, twice as many report positive versus negative effects. With regard to effect on attitude toward school, more students who had used alcohol or drugs reported a positive attitude toward school than a negative attitude. These results indicate that students have positive views on the impact of their own substance use than in 1997. See Table 2 -11.
Table 2-11
JUNIOR HIGH/MIDDLE SCHOOL STUDENTS 1999 Effect of Own Use of Alcohol or Drugs on Social Life and Attitude Toward School
Effect Very Positive Positive Negative Very Negative No Effect Social Life 11.4% 9.9% 6.1% 3.4% 69.2% Attitude Toward School 9.8% 7.8% 7.9% 3.9% 70.6%
Note: Only those students who have ever used alcohol or drugs are represented in this table.
Attitudes Concerning Peer Substance Use and Related Behaviors
Students were asked how they felt about someone their age using tobacco, alcohol and drugs. As the figures in Table 2-12 show, students tend to disapprove of substance use more often than approve of it. Cigarette use, one of the more common substances used among the junior high school population, is the substance in which most students think it is the user's own choice to smoke; howe ver, only 8.0% of students approve of its use. Alcohol, another popular substance, produces much the same attitudes as cigarette use, but more students (9.8%) approve of its use. Attitudes of disapproval of drug use and smokeless tobacco use are the most common attitudes toward these substances. Of junior high school students, 64.2% disapprove of driving under the influence of alcohol, and 62.6% disapprove of driving under the influence of drugs. The percentages of junior high school students who disapprove of these behaviors are lower than the percentages reported by high school students, indicating that in general, high school
28
Substance Abuse in Arizona: 1999
students disapprove of substance use more than junior high school students do. In comparison to 1997, about the same percentage of junior high school students reported an attitude of disapproval for all substances in 1999 than was reported by students in 1997. However, because junior high school students disagree with substance use does not necessarily mean that the respondent hasn't personally used substances. A comparison between substance use attitudes and self-reported use is explored in a later section of this report.
Table 2-12
JUNIOR HIGH/MIDDLE SCHOOL STUDENTS 1999 Attitudes Toward Peer Substance Use and Related Behaviors
Substance/Behavior Cigarettes Smokeless Tobacco Alcohol Drugs DUI: Alcohol DUI: Drugs Approve 8.0% 7.6% 9.8% 8.4% 7.6% 7.7% Do Not Care (No Opinion) 17.4% 17.2% 17.7% 15.0% 11.4% 11.7% Do Not Mind (Own Choice) 35.4% 29.7% 34.2% 27.6% 16.8% 18.0% Disapprove 39.3% 45.5% 38.3% 49.0% 64.2% 62.6%
Driving Under the Influence of Alcohol or Drugs
The substance use survey asked students to report how often they had driven or ridden with a driver under the influence of alcohol or drugs. Slightly fewer students reported both driving under the influence and riding with a driver under the influence than was reported in 1997. In 1999, 8.1% of students had themselves driven under the influence of alcohol or drugs, and 39.0% had ridden with a driver who was under the influence. Table 2-13 provides information on the number of times these events have occurred in the lives of the students.
Table 2-13
JUNIOR HIGH/MIDDLE SCHOOL STUDENTS 1999 Driving, and Riding with a Driver, Under the Influence of Alcohol or Drugs
Response No, never Yes - 1 or 2 times - 3 to 5 times - 6 to 9 times - 10 to 19 times - 20 to 39 times - 40 or more times Total Driven Under the Influence 89.1% 4.2% 1.6% 0.7% 0.6% 0.1% 1.0% 8.1% Ridden with Influenced Driver 57.1% 15.7% 6.9% 4.2% 3.7% 2.3% 6.3% 39.0%
Substance Abuse in Arizona: 1999
29
Differences in Attitudes between Students That Do/Do Not Use Substances
Table 2-14 presents the attitudes of students toward substance use broken down by those who use or do not use a substance. For example, among students who have smoked before, 8.3% reported they approve of cigarette use. Over 20% of students who have smoked cigarettes before report they disapprove of smoking. In general, whether or not they have ever smoked, students were more likely to approve of smoking in 1999 than they were in 1997. Among students who have used alcohol, reported attitudes toward alcohol use have changed little since 1997: slightly more students who have never used alcohol approve of its use by their peers.
Table 2-14
JUNIOR HIGH/MIDDLE SCHOOL STUDENTS 1999 Comparison Between Attitudes Toward Peer Substance Use and Related Behaviors and Own Same Behaviors (Ever in Life)
Substance/ Behavior Cigarettes Smokeless Tobacco Alcohol Own Use/ Behavior Yes No Yes No Yes No Approve 8.3% 7.8% 14.8% 6.9% 11.5% 8.2% Do Not Care (No Opinion) 25.3% 12.0% 27.0% 16.1% 24.5% 10.8% Do Not Mind (Own Choice) 45.4% 28.6% 39.9% 28.7% 43.9% 24.7% Disapprove 21.1% 51.6% 18.3% 48.4% 20.1% 56.3%
Relationship Between Substance Use and Selected Factors
This section contains information regarding the extent of substance use of junior high school students by school achievement and participation in extracurricular activities. Again, causal conclusions should not be drawn from the presented findings. The magnitude of any apparent differences between groups requires careful consideration and analysis that exceeds the scope of this report.
School Achievement
This section examines the impact of self-reported grades on substance use. Table 2-15 shows that of all students, regardless of drug use history, 56.5% reported they made either all A's, all B's, or some combination of A's and B's. It is significant to note the low percentage of students who reported in the "D's and F's" category. When comparing these variables with uncommonly used substances, such as depressants or steroids, their impact requires cautious interpretation.
30
Substance Abuse in Arizona: 1999
Table 2-15
JUNIOR HIGH/MIDDLE SCHOOL STUDENTS 1999 Self Reported Grades
Grades All or Mostly A's Mostly A's and B's All or Mostly B's Mostly B's and C's All or Mostly C's Mostly C's and D's All or Mostly D's Mostly D's and F's All or Mostly F's Percentage 16.1% 30.6% 9.8% 22.1% 6.8% 8.4% 1.2% 3.4% 1.7%
Table 2-16 shows that the relationship between school achievement and substance use generally follows a pattern: levels of substance use generally increase as the level of achievement decreases. Unlike the correlation between grades and high school student substance use, most junior high school substance use increases are particularly large between grades, such as the increase between cigarette use, which rises from 25.3% among students making A's to 64.0% of students making D's and F's. Cocaine use rises from 3.1% of students receiving all A's to 17.1% of students receiving D's and F's. Methamphetamine use is also much higher for individuals with D's and F's (16.1%) as opposed to students receiving A's (3.3%).
Table 2-16
JUNIOR HIGH/MIDDLE SCHOOL STUDENTS 1999 Substance Use Ever in Life: Self Reported Grade Comparison
Substance Cigarettes Smokeless Tobacco Alcohol Marijuana Cocaine Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids A's 25.3% 7.2% 35.6% 13.4% 3.1% 3.3% 3.1% 8.5% 4.0% 2.8% 3.3% A's & B' s 32.3% 6.3% 41.5% 15.1% 2.7% 2.8% 3.1% 13.5% 3.3% 2.5% 2.4% B's 40.3% 7.3% 52.1% 24.2% 4.2% 3.6% 3.3% 17.0% 5.8% 3.0% 2.4% B's & C's 45.9% 9.3% 57.4% 24.1% 5.6% 4.3% 5.2% 20.4% 5.9% 4.2% 3.6% C's 51.6% 18.8% 60.7% 31.9% 7.0% 7.9% 5.7% 27.1% 8.3% 6.6% 5.7% C's & D's 50.3% 10.6% 56.4% 31.0% 6.0% 7.7% 8.5% 23.6% 8.1% 9.5% 6.3% D's & F's 64.0% 19.5% 64.5% 43.1% 17.1% 16.1% 15.6% 36.0% 15.6% 16.6% 14.7%
5
5
The "D's and F's" column includes students who reported they received D's, D's and F's, or all F's. These three categories were collapsed to provide a more reliable analysis. The actual number of students who reported these grades and used substances were insufficient to provide a valid conclusion individually. 31
Substance Abuse in Arizona: 1999
Participation in Extracurricular Activities
It has been suggested that if students had other activities in which to participate or an after-school job, they would be less likely to engage in unhealthy and/or dangerous habits such as substance use. Table 2-17 shows that of all junior high school students surveyed, 60.2% participated in school related activities, 49.3% participated in outside school activities and 19.1% were employed. This examines the possible relationship between substance use and extracurricular activities.
Table 2-17
JUNIOR HIGH/MIDDLE SCHOOL STUDENTS 1999 Participation in Extracurricular Activities
Participation Yes No School Activities 60.2% 39.8% Outside School Activities 49.3% 50.7% Employment 19.1% 80.9%
Table 2-18 presents the comparison of use among students involved in extracurricular activities and/or employed and those students who do not participate in extracurricular activities and/or are unemployed. Overall, both types of extracurricular activities yielded similar patterns, with lower levels of use apparent among students who participated in after school or outside-of-school extracurricular activities. Employed students report higher levels of lifetime use for all substances.
Table 2-18
JUNIOR HIGH/MIDDLE SCHOOL STUDENTS 1999 Substance Use Ever in Life: Extracurricular Activity and Employment Participation Comparison
School Activities Substance Cigarettes Smokeless Tobacco Alcohol Marijuana Cocaine Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids Yes 38.2% 8.1% 48.5% 19.1% 3.8% 4.0% 4.3% 16.5% 4.8% 3.9% 3.4% No 42.5% 11.1% 50.4% 26.5% 7.0% 6.6% 6.1% 20.0% 7.2% 6.1% 5.2% Outside School Activities Yes No 38.3% 8.2% 48.4% 19.5% 4.2% 4.3% 4.9% 16.3% 5.4% 4.6% 4.1% 41.5% 10.2% 50.2% 24.4% 5.9% 5.6% 5.2% 19.1% 6.0% 4.9% 4.1% Employment Yes 50.5% 15.5% 60.1% 33.1% 10.3% 10.9% 10.0% 27.8% 12.8% 11.4% 10.9% No 37.4% 7.7% 46.6% 19.4% 3.9% 3.6% 4.0% 15.5% 4.1% 3.3% 2.6%
32
Substance Abuse in Arizona: 1999
Conclusions
This in-depth review of substance abuse by junior high school students reveals that: Most substance use among junior high school students is remaining constant. In terms of most lifetime, monthly, and weekly use, junior high school students have either decreased or maintained their levels of use. Female junior high school students are using substances at similar rates to male students. Those junior high school students who make better grades tend to use substances less freque ntly than those students who make lower grades. Students who participate in extracurricular activities tend to use substances less frequently than students who do not participate.
Substance Abuse in Arizona: 1999
33
34
Substance Abuse in Arizona: 1999
HIGH SCHOOL STUDENTS
Introduction
This survey was conducted across the state using a sample of students rather than the entire student population, but is representative of the entire student population. In 1999, a total of 4,588 public high school students across the state participated in the substance use survey. The sex, race, and grade distributions presented here are representative of the state student population. The sex breakdown of the 1999 high school sample is as follows: 49.7% females and 50.3% males. These figures are almost identical to the state's population of high school students. Differences in the results on the basis of sex are unlikely due to the make up of the sample. The racial make-up of the high school sample was also similar to the racial breakdown of Arizona high school students. The racial breakdown is as follows: 58.4% White (not Hispanic), 21.3% Hispanic, 9.6% American Indian, 1.9% Asian, 2.5% Black (not Hispanic), and 6.3% Other. White students were not oversampled, and an accurate racial breakdown of high school students is reflected. It can therefore be assumed that any differences in the survey results will not be due to the racial make up of the sample. The grade ranges represented in the sample are evenly distributed, with a gradual decline in the percentages as grade level increases. The 1999 high school sample contains 26.5% ninth graders, 26.3% tenth graders, 23.5% eleventh graders, and 20.3% twelfth graders. These proportions are consistent with the state's grade breakdown of high school students. Differences in the results of the survey on the basis of grade are assumed to be due to the distinct behaviors of the grade level rather than the make up of the sample.
Prevalence of Substance Use: Ever in Life, Last Month and Last Week
According to the 1999 survey results, alcohol and cigarettes are the most frequently used substances among high school students (see Table 3-1). Marijuana is the third most commonly used substance across all three temporal measures. Over three quarters of surveyed high school students reported trying alcohol, 62.6% reported trying cigarettes and 49.5% reported trying marijuana. Approximately one-fifth of these students report trying inhalants and smokeless tobacco, but their monthly and weekly use reported drops more sharply than any of the other surveyed substances. Approximately nineteen percent report trying hallucinogens, and 12.6% report trying amphetamines/methamphetamines. Just under 15% report using cocaine, less than 10 % report using depressants and 10.2% report use of narcotics. Steroids have been used b y 4.1% of the surveyed students, an increase of 63% over the 1997 rate.
Substance Abuse in Arizona: 1999
35
Table 3-1
HIGH SCHOOL STUDENTS 1999 Substance Use: Ever in Life, In the Last Month and In the Last Week
Substance Cigarettes Smokeless Tobacco Alcohol Marijuana Cocaine Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids Ever in Life 62.6% 22.3% 77.6% 49.5% 14.2% 12.6% 9.6% 21.1% 18.6% 10.2% 4.1% In Last Month 26.1% 6.7% 45.4% 24.7% 5.4% 4.8% 4.7% 5.5% 8.6% 4.8% 2.4% In Last Week 19.8% 3.7% 26.9% 18.0% 3.2% 3.0% 3.4% 3.6% 5.0% 3.4% 2.1%
Except for alcohol use, less than 50% of students who have tried individual substances in their lifetime report using in the last month. Close to 60% of those who have tried alcohol report doing so within the last month. Overall, while the differences in percentages between high school students who have used in the last month and those who have used in the last week are considerably smaller, the proportion of students who reported they have used alcohol in the last week is approximately half the proportion of students who have used in the last month.
Comparison to 1997 High School Substance Use Rates
The rates presented above do not indicate whether substance use is increasing or decreasing, but comparison of the 1997 rates to those in 1999 helps in determining substance use trends among Arizona high school students. In comparing the 1999 survey results to the 1997 results, it is found that among all students who have used (in their lifetime, in the last month and/or in the last week): Cigarette, smokeless tobacco and methamphetamine use is lower than in 1997; Alcohol, cocaine, inhalant, narcotic and steroid use is higher; and Marijuana, depressant and hallucinogen use has not changed. A more in-depth discussion of these trends is presented later in this chapter.
Comparison to 1998 National Data of High School Seniors
To compare substance use rates in Arizona with national rates, data for Arizona high school seniors (class of 1999) was compared with national high school data from the Monitoring the Future survey. (See Table 3 -2.) Comparisons show that: The proportions of Arizona seniors who have smoked cigarettes or had an alcoholic drink are comparable to other seniors across the nation.
36
Substance Abuse in Arizona: 1999
Arizona seniors have used steroids, inhalants, marijuana and cocaine at higher rates than the national data reports. Further, Arizona seniors have a much higher cocaine rate, at twice the national rate. Fewer Arizona seniors are smoking on a monthly basis than their counterparts nationwide. This may be due to the strong presence of the anti-smoking campaign such as the Tobacco Education Prevention Program. Arizona seniors use marijuana, inhalants and steroids at higher rates than reported in the national survey. Monthly cocaine use is t ice as prevalent in Arizona as w across the nation. COMPARISON BETWEEN NATIONAL AND ARIZONA HIGH SCHOOL SENIORS Substance Use: Ever in Life and In the Last Month
Ever in Life Nation6 Arizona Cigarettes Smokeless Tobacco Alcohol Marijuana/Hashish Cocaine (not Crack) Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids 65.3% N/A 81.4% 49.1% 9.3% N/A N/A 15.2% N/A N/A 2.7% 66.9% 29.6% 84.4% 57.9% 18.1% 15.5% 11.2% 18.6% 24.9% 12.4% 3.8% In Last Month Nation Arizona 35.1% N/A 52.0% 22.8% 2.5% N/A N/A 2.3% N/A N/A 1.1% 13.9% 8.8% 53.7% 27.8% 5.5% 5.6% 5.9% 5.6% 10.2% 5.9% 3.2%
Table 3-2
Trends Among High School Students in Arizona: 1991 to 1999
A comparison of public high school students' use from 1991 to 1999 reveals that use levels for most substances (for which data are available) have fluctuated. Tables 3-3, 34, and 3-5 show this is true for all three temporal measures of use: ever in life, in the last month and in the last week. However, because substance use may be higher among students who have ever tried a substance in their lives, continued use (such as on a monthly or weekly basis), may not have increased. In some instances, the increased proportion of students trying a substance but not using it regularly shows that students have made a decision to not use the substance after they have tried it, which is a positive result.
6
Snyder, Howard N., and Sickmund, Melissa. (1999). Juvenile offenders and victims: 1999 National Report. Washington, DC: Office of Juvenile Justice and Delinquency Prevention. Graph shown is a portion of a table adapted by these authors based upon the Monitoring the Future Survey of 1998. 37
Substance Abuse in Arizona: 1999
Table 3-3
HIGH SCHOOL STUDENTS Substance Use Ever in Life: 1991-1999 Comparison7
Substance Cigarettes Smokeless Tobacco Alcohol Marijuana Cocaine Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids 1991 N/A N/A 74.9% 33.5% 9.4% 10.2% 14.9% 15.9% 12.7% 9.7% N/A 1993 N/A N/A 67.1% 36.9% 8.4% 10.1% 11.4% 19.1% 10.5% 7.8% 3.3% 1995 N/A N/A 68.8% 44.1% 10.7% 15.7% 14.4% 19.2% 15.9% 10.7% 2.8% 1997 62.7% 24.0% 74.2% 47.4% 11.6% 16.8% 11.2% 25.1% 18.1% 10.5% 2.6% 1999 62.6% 22.3% 77.6% 49.5% 14.2% 12.6% 9.6% 21.1% 18.6% 10.2% 4.1%
Note: This information is not available for cigarettes or smokeless tobacco prior to 1997.
A review of the trends of use for each substance shows that: Cigarette use is slightly lower than the 1997 figure. Smokeless tobacco use has decreased since 1997, and while monthly use is the same in 1999 as it was in 1997, these rates are lower than the rates reported in 1991-1995. Alcohol use (ever in life) has risen since 1993, but monthly and weekly use has changed little. The proportion of students who have ever used marijuana has increased, but the percent of students who use it on a weekly or monthly basis has not risen since 1997. Cocaine use has been rising in all three areas: lifetime, monthly and weekly use. Methamphetamine use in all three areas has declined between 1997 and 1999, but these rates are still higher than 1991 and 1993 rates. The percent of students who have tried depressants has decreased since its peak in 1995, but use on a monthly or weekly basis has not chanced since 1997. Inhalant use (ever in lifetime) has declined between 1997 and 1999, but is still more prevalent than it was on 1995. Hallucinogen use has not changed since 1997. Narcotic use has not changed since 1997. The percent of students who have used steroids has significantly risen, and monthly and weekly use has nearly doubled since 1997.
7
The magnitude of longitudinal changes of all substances should be interpreted carefully as small fluctuations may be due to external factors and may not be indicative of actual trends. 38
Substance Abuse in Arizona: 1999
Table 3-4
HIGH SCHOOL STUDENTS Substance Use In the Last Month: 1991-1999 Comparison
Substance Cigarettes Smokeless Tobacco Alcohol Marijuana Cocaine Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids 1991 26.6% 9.3% 42.8% 12.7% 3.3% 3.5% N/A 4.2% 5.2% N/A N/A 1993 23.3% 9.2% 34.5% 17.1% 3.1% 3.7% N/A 5.1% 3.7% N/A N/A 1995 27.4% 9.6% 37.7% 21.8% 4.5% 5.8% N/A 6.3% 6.7% N/A N/A 1997 31.3% 6.5% 43.4% 25.1% 3.8% 6.6% 4.9% 5.5% 6.4% 4.6% 1.4% 1999 26.1% 6.7% 45.4% 24.7% 5.4% 4.8% 4.7% 5.5% 8.6% 4.8% 2.4%
Note: This information is not available for depressants, narcotics or steroids prior to 1997.
Table 3-5
HIGH SCHOOL STUDENTS Substance Use In the Last Week: 1993-1999 Comparison
Substance Cigarettes Smokeless Tobacco Alcohol Marijuana Cocaine Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids 1993 N/A N/A 21.9% 12.8% 2.9% 3.1% N/A 4.0% 3.1% N/A N/A 1995 N/A N/A 23.8% 16.8% 4.5% 4.2% N/A 4.8% 5.2% N/A N/A 1997 25.3% 4.8% 23.7% 17.5% 2.2% 4.1% 3.1% 3.2% 3.3% 3.0% 1.2% 1999 19.8% 3.7% 26.9% 18.0% 3.2% 3.0% 3.4% 3.6% 5.0% 3.4% 2.1%
Note: Use in the last week was not measured prior to 1993. Also, this information is not available for cigarettes, smokeless tobacco, depressants, narcotics, or steroids prior to 1997.
Substance Abuse in Arizona: 1999
39
Age at First Use: 1999
Table 3-6 represents the age the surveyed substances were first used by high school students. For our sample of high school students, the most common age of initiation of alcohol and marijuana is between the ages of 11 and 16. The age of initiation for cigarette and inhalant use is 11 to 13 years. For the remaining substances, the 14 to 16 age range was reported as the most common age of initiation. In 1999, the age of first marijuana and alcohol use was later than the same aged students surve yed in 1997.
Table 3-6
HIGH SCHOOL STUDENTS 1999 Substance Use: Age at First Use
Substance Cigarettes Smokeless Tobacco Alcohol Marijuana Cocaine Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids 7 or younger 9.0% 12.0% 14.9% 3.7% 6.4% 7.5% 10.5% 6.5% 5.3% 7.8% 19.1% 8 - 10 20.4% 17.7% 14.2% 9.7% 4.3% 4.4% 8.3% 12.2% 4.0% 10.2% 8.0% 11 - 13 42.6% 30.2% 33.9% 41.6% 20.2% 22.7% 27.9% 46.9% 20.8% 26.6% 26.2% 14 - 16 25.8% 35.2% 33.8% 41.8% 59.1% 57.6% 47.4% 31.1% 60.5% 47.4% 43.1% 17 or older 2.1% 4.8% 3.3% 3.3% 9.9% 7.9% 6.0% 3.2% 9.4% 8.0% 8.0%
Note: This table includes only those students who report ever using each substance.
Demographic Comparisons: Students Who Have Used a Substance at Least Once in Their Lives
Before implementing a drug prevention or intervention program, it is helpful to know specifically which groups are participating in drug activities to increase the likelihood of successfully administering the program. This section describes the prevalence of substance use among those student who have used a substance at least one time in their lives, breaking this use down by sex, race, and grade. The 1999 survey revealed that substance use, which had previously been more prevalent among males than females, is becoming common to both sexes. This year's survey shows more clearly the closing of the gender gap. Table 3-7 shows that: Females tend to use cigarettes, alcohol, marijuana, cocaine, methamphetamine, depressants, inhalants and narcotics at the same pace as their male counterparts. The largest difference between male and female use occurs in smokeless tobacco, hallucinogen and steroid use-- all of which are used more often among males.
40
Substance Abuse in Arizona: 1999
Table 3-7
HIGH SCHOOL STUDENTS 1999 Substance Use Ever in Life: Sex Comparison
Substance Cigarettes Smokeless Tobacco Alcohol Marijuana Cocaine Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids Female 63.2% 12.3% 79.1% 47.4% 12.8% 13.0% 9.3% 21.2% 15.7% 8.9% 2.2% Male 62.7% 31.9% 77.4% 51.8% 15.2% 12.1% 9.6% 20.7% 21.0% 11.5% 5.5%
A review of drug use among students of different races, Table 3-8 shows that American Indian students have the highest rate of substance use for six substances: cigarettes, smokeless tobacco, marijuana, cocaine, inhalants and narcotics. Black students have the highest steroid use rate, and also high rates of marijuana and depressant use. Students who identify themselves as an "other" racial identity tend to have the highest levels of hallucinogen use, and high levels of cocaine, methamphetamine, depressant and inhalant use. Alcohol use is about the same for all racial identities except for Asian students, who have lower rates of use. For all substances, White or Hispanic students had a comparable or lower rate of substance use than their counterparts.
Table 3-8
HIGH SCHOOL STUDENTS 1999 Substance Use Ever in Life: Race Comparison
Substance Cigarettes Smokeless Tobacco Alcohol Marijuana Cocaine Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids White 59.6% 22.4% 76.2% 44.1% 9.4% 12.1% 8.9% 17.0% 17.2% 8.9% 3.3% Black 60.0% 21.8% 80.0% 63.6% 20.9% 14.5% 12.7% 26.4% 19.1% 17.3% 15.5% Hispanic 64.1% 15.0% 83.1% 52.5% 17.6% 10.8% 8.5% 24.1% 15.7% 7.8% 2.9% American Indian 78.3% 36.9% 78.7% 69.7% 26.7% 13.0% 10.2% 31.0% 13.0% 13.0% 3.3% Asian 53.0% 26.5% 69.9% 43.4% 14.5% 15.7% 10.8% 22.9% 21.7% 16.9% 14.5% Other 68.7% 25.1% 80.4% 57.5% 21.5% 21.1% 17.1% 30.9% 30.9% 20.0% 9.5%
Substance Abuse in Arizona: 1999
41
The data demonstrates that substance use increases as students progress through high school. However, there are three exceptions. First, steroid use does not change between grades, which indicates that those students who use steroids begin doing so in their freshman year or sooner and continue to use throughout their high school career. Second, there is a decrease in narcotics use in the eleventh grade in comparison to other grades. In 1997, 9.8% of ninth graders (who would be eleventh graders in 1999) reported using narcotics. Finally, inhalant use is more prevalent among ninth and tenth graders than among eleventh and twelfth graders. This indicates that inhalant use was more of a younger student's drug; although overall, the rate of inhalant use is not changing. The prevalence of ever in life substance use is presented by grade in Table 3-9.
Table 3-9
HIGH SCHOOL STUDENTS 1999 Substance Use Ever in Life: Grade Comparison
Substance Cigarettes Smokeless Tobacco Alcohol Marijuana Cocaine Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids Ninth 60.0% 17.1% 72.9% 42.7% 10.4% 9.5% 8.6% 24.1% 13.2% 9.2% 4.0% Tenth 61.7% 19.6% 76.6% 47.0% 12.1% 10.8% 8.9% 20.2% 16.4% 9.4% 3.7% Eleventh 65.5% 24.1% 81.4% 54.8% 16.0% 13.7% 8.6% 19.5% 20.2% 8.5% 3.7% Twelfth 66.9% 29.6% 84.4% 57.9% 18.1% 15.5% 11.2% 18.6% 24.9% 12.4% 3.8%
Substance Use While on School Grounds
The Substance Use and Public School Students survey not only asks students about their own use patterns, but asks about their attitudes toward substance use in general. This section presents the survey results examining substance use and school attendance.
Attending School Under the Influence of Alcohol or Drugs
In 1999, fewer students reported they had ever attended school under the influence of drugs than was reported in 1997. This year, less than one third (31.6%) of students reported coming to school under the influence of alcohol or drugs. This is less than the 33.4% of students who reported the same behavior in 1997. The percentage of students who reported they had used drugs or alcohol before, but had never attended school under the influence is higher than what was reported in 1997. This indicates that
42
Substance Abuse in Arizona: 1999
although students are still using, they are less likely to carry these behaviors into the school setting than in 1997. Please see Table 3 -10.
Table 3-10
HIGH SCHOOL STUDENTS 1999 Attending School Under the Influence of Alcohol or Drugs
Use of Alcohol or Drugs Have Never Used Have Used, But Have Never Attended School Under the Influence Have Attended School Under the Influence: - 1 or 2 times - 3 to 5 times - 6 to 9 times - 10 to 19 times - 20 to 39 times - 40 or more times Total Percentage 27.5% 39.1%
9.9% 4.6% 3.0% 3.5% 2.7% 7.9% 31.6%
Student Use of Drugs or Alcohol at School
When comparing the percent of students who atte nd school under the influence of alcohol or drugs to the percent of students who actually use while on school grounds, it appears that nearly as many students use substances while on campus (24.8%). Almost 5% of surveyed high school students report using alcohol or drugs at school forty or more times in their lives. See Table 3-11.
Table 3-11
HIGH SCHOOL STUDENTS 1999 Use of Alcohol or Drugs at School (Ever in Life)
Use of Alcohol or Drugs Have Never Used Have Used, But Have Never Used at School During Regular School Hours Have Used at School During Regular School Hours: - 1 or 2 times - 3 to 5 times - 6 to 9 times - 10 to 19 times - 20 to 39 times - 40 or more times - Total Percentage 28.2% 45.2%
9.3% 3.8% 2.4% 2.8% 2.4% 4.1% 24.8%
Substance Abuse in Arizona: 1999
43
Attitudes and Perceptions Concerning Substance Use
Attitudes and perceptions about drug use drive overall substance consumption patterns. This section examines attitudes about both self-reported and peer substance use and related behaviors, with a comparison of attitudes toward peer behaviors by students who have participated in the same behaviors.
Perceived Effect of Substance Use on Social Life and Attitude Toward School
The 1999 survey results indicate that approximately two-thirds of high school students who have used alcohol or drugs believe their use has not affected their social lives. Three quarters of those who have used report no effect of their use on their attitude toward school. Of those students who report some type of effect on their social life, it appears that twice as many report positive versus negative effects. With regard to effect on attitude toward school, those affected report similar proportions of positive and negative influence. These results are unchanged in comparison to 1997 figures, and are shown in Table 3-12.
Table 3-12
HIGH SCHOOL STUDENTS 1999 Effect of Self Use of Alcohol or Drugs on Social Life and Attitude Toward School
Effect Very Positive Positive Negative Very Negative No Effect Social Life 7.9% 14.0% 6.8% 3.1% 68.2% Attitude Toward School 5.3% 6.3% 10.1% 3.4% 74.9%
Note: Only those students who have ever used alcohol or drugs are represented in this table.
Attitudes Concerning Peer Substance Use and Related Behaviors
Students were asked how they felt about someone their age using tobacco, alcohol and drugs. As the figures in Table 3-13 show, students tend to disapprove of substance use more often than approve of it. For example, more students think that smoking cigarettes, which is common among the high school population, is unacceptable; only 4.2% of students approve of its use in comparison to 32.0% who disapprove. Alcohol, another popular substance, produces much the same attitudes as cigarette use, but more students (11.1%) approve of its use. Disapproval of drug use and smokeless tobacco is the most common attitude toward these substances. More than two thirds of high school students disapprove of driving under the influence of alcohol, and threefourths of high school students disapprove of driving under the influence of drugs. In general, a higher percentage of students reported an attitude of disapproval for all substances in 1999 than was reported by students in 1997.
44
Substance Abuse in Arizona: 1999
However, because high school students disagree with substance use does not necessarily mean that the respondent hasn't personally used substances. A comparison between substance use attitudes and self-reported use is explored in a later section of this report.
Table 3-13
HIGH SCHOOL STUDENTS 1999 Attitudes Toward Peer Substance Use and Related Behaviors
Substance/Behavior Cigarettes Smokeless Tobacco Alcohol Drugs DUI: Alcohol DUI: Drugs Approve 4.2% 3.6% 11.1% 5.1% 3.4% 3.7% Do Not Care (No Opinion) 17.9% 18.4% 18.4% 15.2% 6.1% 9.2% Do Not Mind (Own Choice) 45.9% 38.6% 48.1% 36.8% 9.8% 13.5% Disapprove 32.0% 39.4% 22.4% 42.9% 80.8% 73.6%
Driving Under the Influence of Alcohol or Drugs
The substance use survey also asked students to report how often they had driven or ridden with a driver under the influence of alcohol or drugs. Slightly more students reported both driving under the influence and riding with a driver under the influence than was reported in 1997. In 1999, 25.3% of students had themselves driven under the influence of alcohol or drugs, and 61.7% had ridden with a driver who was under the influence. Refer to Table 3-14 for more information on the number of times these events occurred in the lives of the students.
Table 3-14
HIGH SCHOOL STUDENTS 1999 Driving, and Riding with a Driver, Under the Influence of Alcohol or Drugs
Response No, never Yes - 1 or 2 times - 3 to 5 times - 6 to 9 times - 10 to 19 times - 20 to 39 times - 40 or more times Total Driven Under the Influence 72.9% 9.5% 4.9% 2.7% 2.1% 1.5% 4.7% 25.3% Ridden with Driver Under the Influence 35.7% 17.7% 10.8% 6.6% 6.8% 5.3% 14.4% 61.7%
Substance Abuse in Arizona: 1999
45
Differences in Attitudes Between Students That Do/Do Not Use Substances
Table 3-15 represents the attitudes of students toward substance use broken down by those who use or do not use a substance. For example, among students who have smoked before, 5.4% reported they approve of cigarette use. 20.7% of students who have smoked cigarettes before do not approve of smoking. In general, whether or not they have ever smoked, students were less likely to approve of smoking in 1999 than they were in 1997. More students tended to approve of smokeless tobacco use in 1999 than in 1997, whether or not they have used it before. Attitudes toward alcohol use have changed little since 1997, although slightly more students who have never used alcohol approve of its use by their peers.
Table 3-15
HIGH SCHOOL STUDENTS 1999 Comparison Between Attitudes Toward Peer Substance Use and Related Behaviors and Own Same Behaviors (Ever in Life)
Substance/ Behavior Cigarettes Smokeless Tobacco Alcohol Own Use/ Behavior Yes No Yes No Yes No Approve 5.4% 2.2% 9.4% 2.9% 13.1% 3.9% Do Not Care (No Opinion) 20.9% 12.6% 28.1% 15.7% 20.2% 11.0% Do Not Mind (Own Choice) 53.1% 33.6% 44.7% 45.2% 52.9% 31.3% Disapprove 20.7% 51.6% 17.9% 36.3% 13.8% 53.9%
* Due to the structure of the survey questions, these "own behaviors" include driving under the influence of either or both alcohol or drugs (i.e., these substances are not separated in the "own DUI behavior" question - see copy of survey in Appendix B).
Relationship Between Substance Use and Selected Factors
This section contains information regarding the extent of substance use of high school students by school achievement, and participation in extracurricular activities. Causal conclusions should not be drawn from the presented findings. The magnitudes of any apparent differences between groups warrant careful consideration and analysis that exceeds the scope of this report.
School Achievement
This section examines the impact of self-reported substance abuse by grade level. To begin, Table 3-16 shows that of all students, regardless of drug use history, 54.3% reported they made either all A's, all B's, or some combination of A's and B's. Please note that there are a low percentage of students who reported in the "D's and F's" category.
46
Substance Abuse in Arizona: 1999
Table 3-16
HIGH SCHOOL STUDENTS 1999 Self Reported Grades
Grades All or Mostly A's Mostly A's and B's All or Mostly B's Mostly B's and C's All or Mostly C's Mostly C's and D's All or Mostly D's Mostly D's and F's All or Mostly F's Percentage 16.5% 28.1% 9.7% 24.2% 7.1% 9.0% 1.7% 2.4% 1.2%
Table 3-17 indicates that the relationship between school achievement and substance use is such that levels of substance use generally increase as the level of achievement decreases. Some increases are particularly large, such as the increase between marijuana use, which rises from 27.7% of student making A's to 77.7% of students making D's and F's. Narcotic use rises from 7.9% of students receiving all A's to 26.9% of students receiving D's and F's. Inhalant use is also much higher for individuals with D's and F's (40.3%) as opposed to students receiving A's (13.8%).
Table 3-17
HIGH SCHOOL STUDENTS 1999 Substance Use Ever in Life: Self Reported Grade Comparison
Substance A's A's and B's 55.8% 17.6% 75.0% 41.6% 8.9% 9.0% 6.3% 16.2% 13.6% 7.7% 2.3% B's B's and C's 70.2% 26.0% 83.7% 55.8% 15.9% 13.3% 10.0% 21.8% 20.0% 10.9% 3.5% C's C's and D's 80.2% 27.3% 88.3% 71.5% 21.8% 15.8% 10.5% 29.8% 27.3% 11.5% 4.0% D's and F's8 83.6% 37.4% 88.7% 77.7% 35.3% 27.3% 22.3% 40.3% 37.0% 26.9% 11.8%
Cigarettes Smokeless Tobacco Alcohol Marijuana Cocaine Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids
8
40.2% 16.8% 59.9% 27.7% 9.5% 11.4% 7.8% 13.8% 11.9% 7.9% 5.3%
67.6% 19.0% 82.2% 49.3% 10.4% 10.2% 10.4% 20.1% 16.4% 6.7% 2.3%
72.7% 30.5% 88.6% 63.5% 18.7% 14.9% 13.3% 29.2% 26.3% 12.7% 5.7%
The "D's and F's" column includes students who reported they received D's, D's and F's, or all F's. These three categories were collapsed to provide a more reliable analysis. The actual number of students who reported these grades and used substances were insufficient to provide a valid conclusion individually. 47
Substance Abuse in Arizona: 1999
Participation in Extracurricular Activities
It has been postulated that if students had other activities in which to participate or an after-school job, they would be less inclined toward unhealthy or dangerous habits such as substance use. Table 3-18 shows that of all high school students surveyed, 63.1% participate in school related activities, 56.7% participate in outside school activities, and 42.5% are employed. This section will examine the relationship between substance use and extracurricular activities.
Table 3-18
HIGH SCHOOL STUDENTS 1999 Participation in Extracurricular Activities and Employment
Participation Yes No School Activities 63.1% 36.9% Out-of-School Activities 56.7% 43.3% Employment 42.5% 57.7%
Table 3-19 presents the comparison of use among students involved in extracurricular activities and/or employed and those students who do not participate in extracurricular activities and/or are unemployed. Overall, both types of extracurricular activities yielded similar patterns, with considerably lower levels of drug use among those students who participate in either at-school or outside-of-school extracurricular activities. For both types of extracurricular activity, steroids are the only substances used more frequently among students participating in activities than students who are not involved in extracurricular activities. In terms of employment and substance use, employed students report higher levels of lifetime use for all substances.
Table 3-19
HIGH SCHOOL STUDENTS 1999 Substance Use Ever in Life: Extracurricular Activity and Employment Participation Comparison
Substance Cigarettes Smokeless Tobacco Alcohol Marijuana Cocaine Meth/Amphetamines Depressants Inhalants Hallucinogens Narcotics Steroids
48
School Activities Yes No 58.2% 70.8% 21.9% 23.3% 74.9% 84.1% 42.7% 61.8% 10.3% 20.7% 9.7% 17.6% 7.9% 12.4% 17.7% 26.7% 14.4% 25.5% 7.8% 14.4% 4.3% 3.5%
Out-of-School Activities Yes No 57.1% 70.5% 21.1% 24.1% 74.9% 82.6% 42.8% 58.7% 10.5% 18.8% 10.6% 15.1% 7.9% 11.7% 17.5% 25.5% 14.8% 23.5% 7.8% 13.3% 4.2% 3.6%
Employment Yes No 67.0% 59.8% 28.1% 18.3% 83.7% 74.2% 56.0% 45.0% 17.4% 11.8% 16.5% 9.8% 12.1% 7.8% 22.1% 20.1% 24.0% 14.7% 12.8% 8.2% 5.7% 2.8%
Substance Abuse in Arizona: 1999
Conclusions
This in-depth review of reported high school substance use, reveals the following: Not all substance use among high school students is increasing. About half of the substa nce behaviors in the 1999 survey decreased. High school seniors in Arizona use marijuana, cocaine and inhalants at higher rates than high school seniors across the country. Cocaine use continues to rise in terms of lifetime, monthly and weekly use among high school students. Females are using substances at similar rates to males. Students who make better grades use substances less frequently than those who make lower grades in their classes. With the exception of steroid use, students who participate in ext racurricular activities tend to use substances less frequently than students who do not participate. Students who are employed tend to use substances more often that those students who are not employed.
Substance Abuse in Arizona: 1999
49
50
Substance Abuse in Arizona: 1999
ADULT PROBATIONER SUBSTANCE USE
In the spring of 2000, staff from the Arizona Criminal Justice Commission met with probation officers throughout the state to discuss drug use among probationers. Most of these probation officers were supervising adult offenders. There were a few who supervise juvenile offenders. In all, twenty probation officers from thirteen counties met with Commission staff for one of three group interviews. Their views are the focus of this chapter. The Drug Treatment Education Fund (DTEF) coordinators in the county probation offices across the state work with drug cases and other offenses. However, most cases involve drug use even if the charge was not drug-related. According to Navajo County Probation Department records, 63% of probationers' (adult and juvenile) cases involved substance abuse, even though they may not have been charged with a drug offense. In the same county, 94% of justice court cases are connected to substance abuse, either directly or indirectly. Many of the probation officers interviewed stated that probationers address their issues through the use of drugs and avoid dealing with the root of their problems. The probation officers indicated that most clients really don't want to do drugs, but resort to use because it is easier than dealing with the issues that cause them pain. The probation officers advised that the process of probation is somewhat analogous to surgery: the probationer must be "cut open" and the problem removed before they can begin to heal. This requires a variety of services that may include getting a high school equivalency diploma, attending counseling, participating in residential treatment or intensive probation. Services currently available to probationers and services needed by probation departments to better assist probationers will be discussed in this chapter.
Introduction
According to the collective experiences of the officers interviewed, the "average" probationer in Arizona is male and between 25 and 35 years of age, although some areas such as Bisbee have an older probation population that is proportionate to the general population. This mirrors the findings of the United States Department of Justice Office of Justice Programs that show most probationers to be between the ages of 25 and 34 years of age9. Probationers are usually of a lower socioeconomic status than the general population, and are frequently unemployed. In Bisbee, probationers are often marginally or self-employed. When probationers are employed, usually in a trade occupation, they tend to have a poor employment history a nd poor job skills. In southern areas of the state, namely Santa Cruz County, Willcox, Safford, Elfrida, Douglas and Marana, probationers may hold seasonal (temporary) employment.
9
United States Department of Justice; Office of Justice Programs; Bureau of Justice Statistics. March 1998. Special Report: Substance Abuse and Treatment of Adults on Probation, 1995. 51
Substance Abuse in Arizona: 1999
According to the group interviews with the probation officers, the average probationer has an underreported history of poly-substance abuse. Their impulse control is poor, and they have trouble delaying gratification. In other terms, probationers tend to act on impulse without thinking consequences through; they tend to pursue immediate, shortterm gratification, without concern for long -term effects. The family lives of probationers show a general lack of social support. Probationers tend to be single rather than married. When in a relationship, they typically have poor relations with their partners. The family history of the typical probationer includes not only a poor social support but an array of abuses, including domestic violence, child abuse, and family substance abuse. Typically, there is an intergenerational criminal history in the family according to the probation officers. One probation officer indicated that in his county many male probationers tend to reside with parents/grandparents. Given the current home situation of probationers, they often revert to old behaviors after completing probation. Probationers are usually less educated than the general population. Across Arizona, most probationers have a ninth grade education, dropping out after the freshman year of high school. In Pima County, 44% of probationers ha ve not completed high school. 10 In Maricopa County, the average probationer has not completed the tenth grade. Nationally, 30.2% of adult probationers have not completed high school. 11 Many probationers have learning disabilities and/or mental health issues. The criminal justice history of a probationer can start as young as eight years of age, and doesn't necessarily begin with drug offenses. According to the probation officers interviewed, if probationers are not on probation for a drug -related offense, most are on probation for drug-related crimes 12. On average, probationers in Arizona have seven years of involvement in the criminal justice system. Drug use begins as a juvenile, so by the time the probationer begins their probation they already have a twelve year history of drug abuse that began with alcohol and marijuana use. The probation officers interviewed reported that drug crime is increasing annually. For this reason, a look at probationers' drugs of choice may provide insight into drug crime patterns in Arizona.
Probationer Drugs of Choice
The probation officers interviewed strongly agreed that alcohol, marijuana, methamphetamine and cocaine were the most abused drugs among probationers in their counties. While this is generally true across Arizona , these four drugs are in no particular order; methamphetamine may be the drug of choice in one area while cocaine is the drug of choice in another area.
10
Superior Court of Arizona in Pima County (1999). Adult Probation Department of the Arizona Superior Court in Pima County: Probation: An Excellent Return on Investments. 1999 Annual Report. Tucson, AZ. 11 United States Department of Justice; Office of Justice Programs; Bureau of Justice Statistics (1998). Substance Abuse and Treatment of Adults on Probation, 1995. 12 Drug-related crimes are those crimes that help to support/fund continued drug use. 52
Substance Abuse in Arizona: 1999
Chemically, the probationer drugs of choice result in acute behavior that is criminal in nature.13 Looking at the most common substances used among public school students we can predict the same drugs to remain common and the same behaviors to be manifested among probationers as today's students become adults. Table 4-1 provides a list of areas highly affected by these substances according to the probation officers interviewed. This table is based solely upon the participation of the probation officers interviewed and does not necessarily indicate that drug use may be more prevalent in one county than in a nother. There are two other common substances that, while not agreed upon by all officers across the state, are in need of mention: designer drugs 14 and heroin. Yuma County and some areas of central and northern Arizona have reported an increase in heroin use. Pima County, Sedona and NAU were reported to have increased use in designer/rape drugs.
Table 4-1
PROBATIONERS Areas Highly Affected by Each Drug
(Based Upon the Opinions of the Probation Officers Interviewed) Cochise County, especially Douglas area Gila County Graham County Cocaine Bisbee and Douglas areas of Cochise County Casa Grande and Coolidge areas of Pinal County Santa Cruz County Marijuana Bisbee and Douglas areas of Cochise County Graham County Santa Cruz County Yuma County Methamphetamine Amado area, between Pima and Santa Cruz Counties Cochise County Areas of Mammoth, Oracle, and San Manuel in Pinal County Maricopa County Northern Arizona Counties 15 Pima County Yuma County Alcohol
The probation officers provide some insight as to why these drugs are the drugs of choice. Many drugs are common in an area because of occupational and economic factors. For example, probation officers working in the areas near some interstates
13 14
Personal interview with Vince Carolan, Adult Services Division; Administrative Office of the Courts. The Office of National Drug Control Policy defined "designer drugs" on page 21 of the National Drug Control Strategy: 2000 Report as "a substance on the illegal market that is a chemical analogue or variation of another psychoactive drug". 15 Probation officers in the northern counties reported that the great majority of drug related cases they see involve the use of methamphetamine, although marijuana is still common as well. 53
Substance Abuse in Arizona: 1999
reported that methamphetamine use is high among some employment groups, such as truck drivers because it is sometimes used to keep them awake. Several other probation officers reported that as cocaine becomes more affordable, cocaine users are now often part of the middle class. Just as some areas are experiencing an increase in some substance use, other areas are witnessing a decrease in some substance use. For example, Coconino County has been experiencing a decrease in methamphetamine use. Often, when use of a certain substance drops in an area, the use of another drug increases, but this is not the case in Coconino County. The county cannot yet conclude why this drop has occurred because there has yet to be another drug (called a replacement drug) to take its place.
Assessment of Probationers
At intake, all new probationers are assessed to determine their: (1) risk for reoffending; and (2) level of need for services. 16 The Adult Substance Use Survey (ASUS) is the tool adopted from the state of Colorado that is used to collect this information both at intake (and upon exiting the program) to determine treatment needs of the individual probationer. Also upon intake, a social history is obtained. Higher risk probationers may be assessed further using additional instruments. Probation officers then use these scores and history information to determine the types of services needed by the probationer. Upon exiting the program, the ASUS scores indicate whether or not probation helped the probationer's behavior.
Services Available to Probationers
Once the needs of the probationer are assessed, they are compared with the services available to the probation officer in assisting their probationers. Table 4-2 provides a description of the services probation departments may provide to probationers.
16 Arizona Supreme Court; Administrative Office of the Courts; Adult Services Division. March 1999. Drug Treatment and Education Fund: Legislative Report Fiscal Year 1997-1998. 54
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Table 4-2
PROBATIONERS Services Probation Departments May Provide to Probationers
Counseling Educational Group therapy Individual counseling Family preservation model College courses Drug education English as a Second Language General Education Diploma programs Learn Labs Includes monitoring of seriously mentally ill offenders in Pima County IPS/Electronic monitoring in Pima and Santa Cruz Counties Anger management Community placement Crisis intervention Domestic violence prevention services Employability skills curriculum Job placement (Department of Economic Security) Job search Job training Life skills to teach household budgets and parenting programs Mental health services Motivation Non-violence education Residential placement Womens' shelters After care (not available in Graham County) Cognitive intervention program Custodial treatment Day treatment Detoxification Halfway house (not available in Graham County) Intensive outpatient Lapse/relapse Long-term inpatient Outpatient services PHF: Psychiatric Health Facility/Behavioral Therapy Recovery Residential treatment Sex offender treatment SOS: Secular Organizations for Sobriety in Pima County Treatment for seriously mentally ill offenders in Pima County Various substance abuse treatment programs Vocational rehabilitation Twelve-step programs
Monitoring Social Services
Treatment
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Table 4-2 (continued)
Other
Aggravated DUI caseloads Assessments Bus passes (not available in Graham County) Case reviews Changing Lives through Literature program with judge CPP: Community Punishment Program Day reporting Diversion program (not available in Graham County) Drug court DTEF House arrest MADD Phoenix Suns Night Hoops for Maricopa County males aged 18-25 who have completed a life skills class Salvation Army Shock incarceration Spanish speaking probation officers Teen challenge Work furlough Victory outreach
Differences in Programs Between Counties
There are major differences in the types of programs available to probationers and may vary from county to county. There are differences in rural and metropolitan programs. For example, in some rural counties, drug treatment can involve the use of a twelvestep program including cognitive therapy in a group setting. However, twelve-step programs are not used in Maricopa County due to the spiritual nature of the material discussed in these programs 17. The same holds true for the teen challenge program: while some judges strongly support the program, other counties do not widely participate in it because it is spiritual in approach. (However, the Drug Treatment Education Fund coordinator at the Arizona Administrative Office of the Courts has noted that the use of different strategies is an important factor in the success of drug treatment.) Some counties choose to use group counseling rather than individual counseling because they believe that probationers get more out of the group dynamics. Also, there are differences among services due to quality of the services the probation department can afford to provide. For example, alternatives to residential treatment are often used because of the cost of the program; however, these programs often lack the aftercare that more expensive programs offer. All probation officers interviewed agreed on the value of a "wrap around" strategy that integrates the counselor, case manager and probationer working together as a team to achieve the probationer's goals.
17
According to the pamphlet, "This is A.A....an introduction to the AA recovery program", the Alcoholics Anonymous program notes the reliance of its members on a greater power, although they do not refer to any one religion in particular. 56
Substance Abuse in Arizona: 1999
Barriers to Services
Unfortunately, probation offices in rural counties throughout Arizona have a hard time providing services to their clients. One problem is the location of services relative to the probationer. It is common for rural counties to have an inadequate number of providers. The situation becomes even more difficult when the provider and the probationer do not live in the same town. Additionally, many probationers do not have the means of transportation to get to appointments. To solve this problem, many probation departments offer bus passes to their clients, but not all counties are able to provide this service. Similarly, probation officers in rural counties usually have a more difficult time in contacting their clients. A probation officer in a rural area with the same caseload as a probation officer in a metropolitan area will have a more difficult time in visiting their clients as often as they would like to because the distance between the probation department and the client is often so great. Often more time is spent getting to the client than being able to interact with them. The Drug Treatment Education Fund Coordinator at the Administrative Office of the Courts thinks more money is needed to support rural areas. Some counties have found ways to reduce this problem by sharing services with neighboring counties. For example, in providing residential treatment, many rural counties send their probationers to Maricopa and/or Pima counties for the services.
Reported Trends in Probationers' Substance Use
The probation officers participating in the group interviews offered the following insight in substance use trends: Most probation officers agreed that two-thirds of Arizona's probation caseloads are drug related. Probation officers from Gila, Maricopa, Pinal and Yuma Counties agreed this figure was higher, with 80 to 85% of all probationers having substance abuse related issues in their jurisdictions. In Pinal County 25% of indictments are for drug offenses, according to officers of the Pinal County probation office. The City of Douglas in Cochise County is arresting a higher number of middle aged males for DUI, according to the probation officer representing Cochise County. In Tucson, one part of town is no longer worse than another part of town in terms of drug abuse according to the two Pima County probation officers interviewed.
Women on Probation
Not all county probation departments are experiencing an increase in the number of women on probation. While Santa Cruz County is experiencing a decreased female probationer count, other counties are dealing with an increase of female probationers. In Graham County, for example, 30% of probationers are white males, 30% are Hispanic males, and 40% are white women.
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Characteristics of females on probation in Graham County, according to their probation department representative, indicate that 99% of them are methamphetamine users; they have three or more children; they may revert to alcohol while on probation; 90% smoke cigarettes; they start using drugs at 17 years of age; they have a low self-esteem; they are codependent upon a substance abusing male; they are supported in part by Aid to Families with Dependent Children; they have minimal support systems; they fear being alone; and they are victims of domestic violence.
What's Missing
During the group interviews, the probation officers were asked what tools they thought were needed to help in their efforts to reduce substance abuse in Arizona. This section describes their reported needs. In their meeting, the central counties (Gila, Maricopa, Pima, and Pinal) called for a three pronged approach to the treatment of a probationer. They said the probationer, the probation officer, and the treatment providers need to work together as a team to help the probationer achieve the conditions of their probation. However, the officers reported this is sometimes difficult because some treatment providers will work only on the condition of confidentiality. The central counties also felt it was important to include the families in the treatment of the probationer. While all counties acknowledged that the family component was an important one and that family support programs were needed, much less work is done with the families. This happens because a family member or members cannot be required to attend any counseling or other sessions when the probationer is an adult-- only the adult probationer can be required to participate. Maintaining a fully staffed probation department plays a large role in the success of the probationers needing services. In Maricopa County, the average length of employment at the county adult probation department is eighteen months. Changes in staff, coupled with difficulty in recruitment, decrease the assistance the probationers would be receiving otherwise. Probation officers provide an important element for their clients' motivation, and without this quality the productivity of the probationer decreases. For some probation departments, their main problem isn't necessarily the turnover rate that needs to be examined, but rather the need to give the probation departments or courts more tools to affect change. These include the expanded ability to impose jail time when conditions are not met, incentives to keep probationers off drugs, and other sanctions that serve as a "hammer" for continued abuse/neglect of the conditions of probation. Also, most county probation officers stated they would like more in-house programs that are longer and conducted with smaller groups of probationers (lower staff to probationer ratio). The officers also believed the programs that are in place should include an outcome evaluation.
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Finally, probation officers described a lack of services that stems from one or both of the following: (1) lack of funds or (2) grants that are too legislatively controlled. An example of a lack of funds is that placing one probationer in residential treatment can deplete funds, leaving other probationers without the funds for appropriate services. Some materials are not within the allowed budget. In another example, psychiatric services and medications are not used because the funds allocated by counties are insufficient for the provider. Funds are always limited, but there are instances when funds are set aside for a specific purpose, and cannot be used even though expenditures may conform with the mission of the fund. For example, substance users who committed an act of domestic violence or other violent crime are not eligible for substance abuse treatment for limited jurisdiction cases, but some Superior courts believe these probationers should be eligible for services under the grant. In another example, a person on probation for selling drugs is not eligible for substance abuse treatment, but a person on probation for burglary is.
Conclusions
From the group interviews of the probation officers (DTEF coordinators), the following insight was gained: A description of the average probationer was sketched, including family history and criminal justice involvement. Marijuana, alcohol, cocaine and methamphetamine are the drugs of choice of probationers. However, this list is not in order: marijuana use may be higher in one area while alcohol is higher in another area. Services available to the probationer were described along with barriers to implementation. Needs of the probation departments to affect change were explored.
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CONCLUSIONS
The substance abuse data presented in this report has outlined student patterns of substance abuse through the last decade. It has shown that some substances are cyclical in nature by growing and diminishing in popularity as shown in the pattern of lifetime methamphetamine use among high school students. Other drugs have been rising steadily, as shown in the trend of marijuana use among high school students. The probation officers in one of the three group interviews provided remarkable insight into why it is important to look at the substance use patterns of students not currently in the criminal justice system in comparison to adults on probation. When reading through the 1997 version of the Substance Abuse and Public School Students report published by the Arizona Criminal Justice Commission in 1998, several of the probation officers interviewed reported there is a similarity between high school substance use and the substance use among adults in their respective counties. Their observations illustrate an important point: substance use among students should be curtailed as early in life as possible so students will not bri